Provider Demographics
NPI:1982144143
Name:MORGAN, KRISTIN (APRN)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 BRENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-1637
Mailing Address - Country:US
Mailing Address - Phone:859-985-0302
Mailing Address - Fax:
Practice Address - Street 1:234 BRENWOOD ST
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-1637
Practice Address - Country:US
Practice Address - Phone:859-935-0203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011164363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily