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NPI Code Detail

MEDICARE: KRISTEN MAREE MORRISON PA-C

MEDICARE: KRISTEN MAREE MORRISON PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantOH

General Provider Information

NPI Number : 1922615954
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN MAREE MORRISON PA-C
Provider Business Mailing Address
First Line : 500 LINCOLN PARK BLVD STE 100
Second Line :
City : KETTERING
State : OH
Zip : 45429-6410
Country : US
Telephone Number : 937-222-3118
Fax Number : 937-222-1436
Provider Business Practice Location Address
First Line : 7700 WASHINGTON VILLAGE DR STE 120
Second Line :
City : DAYTON
State : OH
Zip : 45459-4071
Country : US
Telephone Number : 937-425-4144
Fax Number : 937-425-4146
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2020
Last Update Date : 12/18/2024

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