MEDICARE: MISS KAWANNA MORRIS CPSW, CCSS, CADAC

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
1	171M00000X	Case Manager/Care Coordinator	1726	NM

General Provider Information

NPI Number	:	1922857333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KAWANNA MORRIS CPSW, CCSS, CADAC

Provider Business Mailing Address
First Line	:	400 GOLD AVE SW # 702
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-3283
Country	:	US
Telephone Number	:	505-443-0816
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 GOLD AVE SW # 702
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-3283
Country	:	US
Telephone Number	:	806-443-0816
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2024
Last Update Date	:	03/07/2026

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