Provider Demographics
NPI:1215003264
Name:MORROW, BETH ETTA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ETTA
Last Name:MORROW
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:BETH
Other - Middle Name:FOX
Other - Last Name:MORROW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:1311 RING RD
Mailing Address - Street 2:STE 105
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-8963
Mailing Address - Country:US
Mailing Address - Phone:270-862-2226
Mailing Address - Fax:
Practice Address - Street 1:1321 RING RD STE 105
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-8940
Practice Address - Country:US
Practice Address - Phone:270-769-0892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA216363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1066621OtherPASSPORT
KY95002168Medicaid
KY000000 190949OtherANTHEM ALL BLUE PRODUCTS
KY000000 190949OtherANTHEM ALL BLUE PRODUCTS
KY1066621OtherPASSPORT