Provider Demographics
NPI:1992106488
Name:MORRIS, KIMBERLY SMALL (RN)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:SMALL
Last Name:MORRIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 JOE EUBANKS RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:SC
Mailing Address - Zip Code:29321-2923
Mailing Address - Country:US
Mailing Address - Phone:864-577-7675
Mailing Address - Fax:864-577-7629
Practice Address - Street 1:355 CEDAR SPRINGS RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-4628
Practice Address - Country:US
Practice Address - Phone:864-577-7675
Practice Address - Fax:864-577-7629
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC70393163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool