Provider Demographics
NPI:1861267940
Name:MORRIS, CASEY LANE (PHARMACY INTERN)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:LANE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PHARMACY INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 LEVELWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-6001
Mailing Address - Country:US
Mailing Address - Phone:270-849-4435
Mailing Address - Fax:
Practice Address - Street 1:1160 LEVELWOOD RD
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-6001
Practice Address - Country:US
Practice Address - Phone:270-849-4435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYL15437390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program