Provider Demographics
NPI:1033296421
Name:MORROW, KELLY ANN (PHD)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:MORROW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 MERCY RD
Mailing Address - Street 2:# 130
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-2621
Mailing Address - Country:US
Mailing Address - Phone:402-397-4084
Mailing Address - Fax:402-390-9851
Practice Address - Street 1:6901 MERCY RD
Practice Address - Street 2:# 130
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-2621
Practice Address - Country:US
Practice Address - Phone:402-390-6600
Practice Address - Fax:402-390-9851
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE359103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47067556126Medicaid
NE47067556126Medicaid