Healthcare Provider Details

I. General information

NPI: 1013385079
Provider Name (Legal Business Name): MORGAN ELIZABETH HARRIS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2015
Last Update Date: 09/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S MAJOR ST
EUREKA IL
61530-1246
US

IV. Provider business mailing address

105 S MAJOR ST
EUREKA IL
61530-1246
US

V. Phone/Fax

Practice location:
  • Phone: 309-467-4691
  • Fax:
Mailing address:
  • Phone: 309-467-4691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209013148
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: