Provider Demographics
NPI:1528024734
Name:NANCY V MORRIS MD PLLC
Entity Type:Organization
Organization Name:NANCY V MORRIS MD PLLC
Other - Org Name:LAUREL MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:V
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-877-2050
Mailing Address - Street 1:175 CITY HILL DR
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-3038
Mailing Address - Country:US
Mailing Address - Phone:606-877-2050
Mailing Address - Fax:606-877-2080
Practice Address - Street 1:175 CITY HILL DR
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-3038
Practice Address - Country:US
Practice Address - Phone:606-877-2050
Practice Address - Fax:606-877-2080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38962207Q00000X
KY32043207R00000X
KYPA430363A00000X
KY5204P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000479659OtherBCBS OF KY
KY7100025400Medicaid
KY00005Medicare PIN
KY7100025400Medicaid