Provider Demographics
NPI:1194492587
Name:MORRIS, KELSEY A (PA-C)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:A
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:PO BOX 14
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18067-0014
Mailing Address - Country:US
Mailing Address - Phone:484-274-2349
Mailing Address - Fax:
Practice Address - Street 1:179 W 28TH ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18067-1024
Practice Address - Country:US
Practice Address - Phone:484-274-2349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA005787363A00000X
PAMA062809363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant