Healthcare Provider Details

I. General information

NPI: 1124834080
Provider Name (Legal Business Name): MORGAN BRISTER UTSCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 CLIFTON RD NE BLDG C
ATLANTA GA
30322-1013
US

IV. Provider business mailing address

3918 E BROOKHAVEN DR NE
BROOKHAVEN GA
30319-2808
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-1900
  • Fax:
Mailing address:
  • Phone: 404-556-9669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP313827
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP313827
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: