Basic Information
Provider Information
NPI: 1316141971
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORRIS
FirstName: KATHLEEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 900 W BROADWAY ST
Address2:  
City: NEWTON
State: KS
PostalCode: 671142037
CountryCode: US
TelephoneNumber: 3162831950
FaxNumber: 3162839540
Practice Location
Address1: 900 W BROADWAY ST
Address2:  
City: NEWTON
State: KS
PostalCode: 671142037
CountryCode: US
TelephoneNumber: 3162831950
FaxNumber: 3162834054
Other Information
ProviderEnumerationDate: 06/14/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WP0807X13-60520-091KSY Nursing Service ProvidersRegistered NursePsych/Mental Health, Child & Adolescent

No ID Information.


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