Provider Demographics
NPI:1558929414
Name:MORELL, KATIE ANN (FNP-C)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ANN
Last Name:MORELL
Suffix:
Gender:F
Credentials:FNP-C
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1035 W WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-2929
Mailing Address - Country:US
Mailing Address - Phone:316-277-1182
Mailing Address - Fax:231-363-1822
Practice Address - Street 1:740 S MAIN ST STE FL2
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-2220
Practice Address - Country:US
Practice Address - Phone:231-627-7118
Practice Address - Fax:231-627-1838
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704259688363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704259688OtherDEPARTMENT OF LICENSING AND REGULATORY AFFAIRS BUREAU OF PROFESSIONAL LICENSING