Healthcare Provider Details
I. General information
NPI: 1093782773
Provider Name (Legal Business Name): BRIGID Q MORGAN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/02/2006
Last Update Date: 08/09/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2401 E ORANGEBURG AVE STE 300
MODESTO CA
95355-3971
US
IV. Provider business mailing address
310 HOSPITAL AVE
JEFFERSON NC
28643
US
V. Phone/Fax
- Phone: 209-724-6000
- Fax:
- Phone: 366-846-6322
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 2608 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 64462 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: