Provider Demographics
NPI:1568155307
Name:MORRISON, CAROLINE MARIE (PA)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:MARIE
Last Name:MORRISON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 SAXON LN
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-8783
Mailing Address - Country:US
Mailing Address - Phone:270-792-8323
Mailing Address - Fax:
Practice Address - Street 1:740 S LIMESTONE STE D200
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-8783
Practice Address - Country:US
Practice Address - Phone:859-323-6700
Practice Address - Fax:859-257-1331
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-29
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTC007363AS0400X, 363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical