Provider Demographics
NPI:1508820127
Name:MORRIS, JEANETT S (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JEANETT
Middle Name:S
Last Name:MORRIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2357
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002
Mailing Address - Country:US
Mailing Address - Phone:270-444-9625
Mailing Address - Fax:270-575-5458
Practice Address - Street 1:916 KENTUCKY AVE
Practice Address - Street 2:PADUCAH-MCCRACKEN COUNTY HEALTH CENTER
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001
Practice Address - Country:US
Practice Address - Phone:270-444-9631
Practice Address - Fax:270-442-8769
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYRN 1031814363L00000X
KYARNP 1007P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
0279404Medicare ID - Type Unspecified
0279604Medicare ID - Type Unspecified
NPP000Medicare UPIN
0279304Medicare ID - Type Unspecified
0279504Medicare ID - Type Unspecified
0279204Medicare ID - Type Unspecified
0279704Medicare ID - Type Unspecified
0224020Medicare ID - Type Unspecified
0279804Medicare ID - Type Unspecified