Healthcare Provider Details

I. General information

NPI: 1871194860
Provider Name (Legal Business Name): MORGAN SLAWSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2020
Last Update Date: 07/29/2021
Certification Date: 07/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 MACARTHUR BLVD STE 404
MUNSTER IN
46321-2919
US

IV. Provider business mailing address

3025 AMBERLEIGH LN
SCHERERVILLE IN
46375-4365
US

V. Phone/Fax

Practice location:
  • Phone: 219-836-2995
  • Fax: 219-836-4075
Mailing address:
  • Phone: 219-765-0107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28206923A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041425365
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number71011191A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: