Healthcare Provider Details

I. General information

NPI: 1982526349
Provider Name (Legal Business Name): MORGAN ELISE SANFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 RONALD REAGAN PKWY
AVON IN
46123-7085
US

IV. Provider business mailing address

7862 HUNTERS PATH
INDIANAPOLIS IN
46214-1533
US

V. Phone/Fax

Practice location:
  • Phone: 317-400-2836
  • Fax:
Mailing address:
  • Phone: 317-400-2836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number28280298A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: