MEDICARE: CHANDA J MORRIS CRNA

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	367500000X	Certified Registered Nurse Anesthetist	00084720	OK
2	367500000X	Certified Registered Nurse Anesthetist	557308	KS

General Provider Information

NPI Number	:	1942582994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANDA J MORRIS CRNA

Provider Business Mailing Address
First Line	:	210 W 1ST ST
Second Line	:
City	:	SAINT FRANCIS
State	:	KS
Zip	:	67756-3540
Country	:	US
Telephone Number	:	853-322-1047
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 W 1ST ST
Second Line	:
City	:	SAINT FRANCIS
State	:	KS
Zip	:	67756-3540
Country	:	US
Telephone Number	:	785-332-2104
Fax Number	:

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

Provider Enumeration Date	:	09/15/2011
Last Update Date	:	08/10/2020

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