Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | G79806 | CA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | G79806 | CA |
NPI | 1770513202 |
---|---|
Provider Name | Kathryn Ann Morsea |
First Address | Gallup, NM 87301-5748 |
Second Address | Gallup, NM 87301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 25/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00077473 | (05) | NM |
501719 | (05) | AZ |
G39549 | (02) |