Provider Demographics
NPI:1558516088
Name:MORRIS, CORRIE FLYNN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:CORRIE
Middle Name:FLYNN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1720 NICHOLASVILLE RD
Mailing Address - Street 2:601
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1404
Mailing Address - Country:US
Mailing Address - Phone:859-277-5887
Mailing Address - Fax:859-276-7659
Practice Address - Street 1:1720 NICHOLASVILLE RD
Practice Address - Street 2:601
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1404
Practice Address - Country:US
Practice Address - Phone:859-277-5887
Practice Address - Fax:859-276-7659
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3008854363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100312510Medicaid
KYK167490Medicare PIN