Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FX1700X | Ocularist | ||
Y | 156FX1800X | Optician |
NPI | 1336114081 |
---|---|
Provider Name | Ginger Morrell |
First Address | Hutchinson, KS 67502-1131 |
Second Address | Hutchinson, KS 67502-1131 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 24/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100426350A | (05) | KS |