Healthcare Provider Details

I. General information

NPI: 1033587829
Provider Name (Legal Business Name): MORGAN ANDREA MASSEY APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2015
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S CENTER ST STE 201
CLINTON IL
61727-1958
US

IV. Provider business mailing address

100 S CENTER ST STE 201
CLINTON IL
61727-1958
US

V. Phone/Fax

Practice location:
  • Phone: 309-682-0374
  • Fax: 309-250-1124
Mailing address:
  • Phone: 309-682-0374
  • Fax: 309-250-1124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209013406
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277004827
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: