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NPI Code Detail

MEDICARE: MRS. AMY BROOKE MORGAN RN

MEDICARE: MRS. AMY BROOKE MORGAN RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0808XPsychiatric/Mental Health Registered Nurse181876-3101UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1181876-3101OTHERUTSTATE OF UTAH

General Provider Information

NPI Number : 1366038093
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY BROOKE MORGAN RN
Provider Business Mailing Address
First Line : 45 W SEGO LILY DR STE 312
Second Line :
City : SANDY
State : UT
Zip : 84070-3643
Country : US
Telephone Number : 801-676-9452
Fax Number : 801-206-9734
Provider Business Practice Location Address
First Line : 45 W SEGO LILY DR STE 312
Second Line :
City : SANDY
State : UT
Zip : 84070-3643
Country : US
Telephone Number : 801-676-9452
Fax Number : 801-206-9734
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2020
Last Update Date : 01/13/2021

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