Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | 667798 | TX |
NPI | 1093734535 |
---|---|
Provider Name | Carla K Morrow |
First Address | Cleburne, TX 76033-4007 |
Second Address | Fort Worth, TX 76104-3179 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 09/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
189717501 | (05) | TX |
8Y1550 | BCBS (01) | TX |
P00800369 | RAILROAD MEDICARE (01) | TX |
Q78635 | (02) | TX |