Healthcare Provider Details

I. General information

NPI: 1497878300
Provider Name (Legal Business Name): HEATHER LYNN MORGAN M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 06/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3033 CABELA LN
CRESTVIEW FL
32539-9401
US

IV. Provider business mailing address

3033 CABELA LN
CRESTVIEW FL
32539-9401
US

V. Phone/Fax

Practice location:
  • Phone: 770-316-8703
  • Fax:
Mailing address:
  • Phone: 770-316-8703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License NumberPT007716
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number1185580
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: