Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 5029 | NC |
NPI | 1023350550 |
---|---|
Provider Name | Miss Karen Lucia Morris |
First Address | Charlotte, NC 28213-4066 |
Second Address | Greensboro, NC 27401-1863 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2013 |
Last Update Date | 22/03/2013 |