Provider Demographics
NPI:1306508189
Name:MORRELL ADVANCED PRACTICE LLC
Entity type:Organization
Organization Name:MORRELL ADVANCED PRACTICE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CAITLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRELL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:304-393-5094
Mailing Address - Street 1:4540 OLD 126
Mailing Address - Street 2:
Mailing Address - City:WARFORDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17267-7934
Mailing Address - Country:US
Mailing Address - Phone:304-393-5094
Mailing Address - Fax:855-631-6386
Practice Address - Street 1:4540 OLD 126
Practice Address - Street 2:
Practice Address - City:WARFORDSBURG
Practice Address - State:PA
Practice Address - Zip Code:17267-7934
Practice Address - Country:US
Practice Address - Phone:304-393-5094
Practice Address - Fax:855-631-6386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-09
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health