Healthcare Provider Details

I. General information

NPI: 1891535043
Provider Name (Legal Business Name): MORGAN ROSE HARLAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2024
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3104 BLUE LAKE DR
VESTAVIA AL
35243-2345
US

IV. Provider business mailing address

9123 AMELIA DR
MOBILE AL
36695-7802
US

V. Phone/Fax

Practice location:
  • Phone: 205-977-1949
  • Fax:
Mailing address:
  • Phone: 251-510-8181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1-178356
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: