Provider Demographics
NPI:1275717753
Name:MORRIS, LARA C (APRN)
Entity type:Individual
Prefix:
First Name:LARA
Middle Name:C
Last Name:MORRIS
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:UK DIVISION OF HEMATOLOGY
Mailing Address - Street 2:800 ROSE ST
Mailing Address - City:LEXINGTON
Mailing Address - State:KENTUCKY
Mailing Address - Zip Code:40536
Mailing Address - Country:UM
Mailing Address - Phone:859-257-6006
Mailing Address - Fax:859-323-2749
Practice Address - Street 1:UK DIVISION OF HEMATOLOGY
Practice Address - Street 2:800 ROSE ST.
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0093
Practice Address - Country:US
Practice Address - Phone:859-257-6006
Practice Address - Fax:859-323-2749
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005400363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100055470Medicaid
KY00582Medicare PIN
KY00582002Medicare PIN