Provider Demographics
NPI:1326686817
Name:MORRIS, KYLIE ELISE (APRN)
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:ELISE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KYLIE
Other - Middle Name:ELISE
Other - Last Name:HALUPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:224 TAD WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-8369
Mailing Address - Country:US
Mailing Address - Phone:909-930-7034
Mailing Address - Fax:
Practice Address - Street 1:7777 FOREST LANE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230
Practice Address - Country:US
Practice Address - Phone:972-566-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-15
Last Update Date:2019-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144340363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty