MEDICARE: MRS. STEPHANIE S MORGAN FNP-BC

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
1	363LF0000X	Family Nurse Practitioner	R43806	NM
2	363LF0000X	Family Nurse Practitioner	566449	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8Y4027	OTHER	TX	BCBS PVN

General Provider Information

NPI Number	:	1558315317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEPHANIE S MORGAN FNP-BC

Provider Business Mailing Address
First Line	:	348 FOREST LAKE DR
Second Line	:
City	:	DEL VALLE
State	:	TX
Zip	:	78617-5668
Country	:	US
Telephone Number	:	512-983-7521
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 W LOUIS HENNA BLVD STE 100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78728-1702
Country	:	US
Telephone Number	:	855-481-8375
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	08/15/2023

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