Individual
MORGAN FREEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
36500 NYS RT 26, CARTHAGE, NY 13619-9506
(315) 493-5030
Mailing address
36500 NYS RT 26, CARTHAGE, NY 13619-9599
(315) 493-5030
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
736904
NY
Other
Enumeration date
04/23/2019
Last updated
04/23/2019
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