Provider Demographics
NPI:1508606658
Name:MORRELL ADVANCED PRACTICE LLC
Entity type:Organization
Organization Name:MORRELL ADVANCED PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAITLYN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MORRELL
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:304-393-5094
Mailing Address - Street 1:339 E ANTIETAM ST STE 1
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5767
Mailing Address - Country:US
Mailing Address - Phone:304-393-5094
Mailing Address - Fax:855-631-6386
Practice Address - Street 1:326 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:MD
Practice Address - Zip Code:21750-1500
Practice Address - Country:US
Practice Address - Phone:304-393-5094
Practice Address - Fax:855-631-6386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty