Provider Demographics
NPI:1457534067
Name:MORFORD, KARY MCPHERSON (APN)
Entity Type:Individual
Prefix:
First Name:KARY
Middle Name:MCPHERSON
Last Name:MORFORD
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10710 OLD HIGHWAY 64
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:TN
Mailing Address - Zip Code:38008-3587
Mailing Address - Country:US
Mailing Address - Phone:731-658-6113
Mailing Address - Fax:
Practice Address - Street 1:844 NATCHEZ TRACE DR N
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-4144
Practice Address - Country:US
Practice Address - Phone:731-967-8803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12456363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1510073Medicaid
TN103I505718Medicare PIN