Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 53008 | TN |
Y | 2080P0204X | Pediatric Emergency Doctor | 53008 | TN |
NPI | 1043576697 |
---|---|
Provider Name | Kristy A Morse |
First Address | Starkville, MS 39759-2604 |
Second Address | Memphis, TN 38103-3403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2012 |
Last Update Date | 07/10/2017 |