Provider Demographics
NPI:1376090571
Name:MORRIS, KACEE CAMP (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KACEE
Middle Name:CAMP
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 E TRIPPE ST
Mailing Address - Street 2:
Mailing Address - City:HARLEM
Mailing Address - State:GA
Mailing Address - Zip Code:30814-5062
Mailing Address - Country:US
Mailing Address - Phone:706-836-3726
Mailing Address - Fax:
Practice Address - Street 1:4150 WASHINGTON RD STE 6
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-4722
Practice Address - Country:US
Practice Address - Phone:706-814-6104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008084363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant