Individual
CAROL MORRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1960 N DATE ST, T OR C, NM 87901-3701
(575) 894-7662
(575) 894-7930
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2002-0033
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19954875
—
NM
Enumeration date
08/25/2005
Last updated
08/01/2011
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