Provider Demographics
NPI:1366790149
Name:MORSE, SHELLY L
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:L
Last Name:MORSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210 SW 10TH AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-2000
Mailing Address - Country:US
Mailing Address - Phone:785-231-9684
Mailing Address - Fax:
Practice Address - Street 1:325 SW FRAZIER AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1963
Practice Address - Country:US
Practice Address - Phone:785-232-5005
Practice Address - Fax:785-232-0160
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker