Provider Demographics
NPI:1194711457
Name:MORRISSETTE, KAREN LEE (MD)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LEE
Last Name:MORRISSETTE
Suffix:
Gender:F
Credentials:MD
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 546
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:AK
Mailing Address - Zip Code:99574-0546
Mailing Address - Country:US
Mailing Address - Phone:928-451-9655
Mailing Address - Fax:
Practice Address - Street 1:508 CHASE AVE
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:AK
Practice Address - Zip Code:99574
Practice Address - Country:US
Practice Address - Phone:907-424-3622
Practice Address - Fax:907-424-3275
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ334572083P0500X
AK63282083P0901X
HI160102083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine