Provider Demographics
NPI:1659979169
Name:MORRIS, SAMANTHA ROSE
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ROSE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:KASTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SAMANTHA KASTMAN
Mailing Address - Street 1:8500 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1837
Mailing Address - Country:US
Mailing Address - Phone:913-553-4995
Mailing Address - Fax:913-273-3093
Practice Address - Street 1:8500 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1837
Practice Address - Country:US
Practice Address - Phone:913-553-4995
Practice Address - Fax:913-273-3093
Is Sole Proprietor?:No
Enumeration Date:2020-10-16
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020034777363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily