Healthcare Provider Details

I. General information

NPI: 1285355909
Provider Name (Legal Business Name): JESSICA LYNN MORGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 09/09/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10240 PARK MEADOWS DR
LONE TREE CO
80124-5425
US

IV. Provider business mailing address

6576 S CATAWBA CIR
AURORA CO
80016-5453
US

V. Phone/Fax

Practice location:
  • Phone: 303-861-3402
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number1630752
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: