Healthcare Provider Details
I. General information
NPI: 1225982739
Provider Name (Legal Business Name): MORGAN ALEXANDRA TAKACS DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1405 N GREEN MOUNT RD STE 240
O FALLON IL
62269-3494
US
IV. Provider business mailing address
416 DUFFY DR
MARINE IL
62061-4400
US
V. Phone/Fax
- Phone: 618-632-9000
- Fax:
- Phone: 410-814-9346
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 2026001361 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 209034509 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: