Healthcare Provider Details

I. General information

NPI: 1730735697
Provider Name (Legal Business Name): MRS. MORGAN ASHLEY PHILLIPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MORGAN ASHLEY MALINOWSKI

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WASHINGTON ST
BOSTON MA
02111-1552
US

IV. Provider business mailing address

140 MOUNT VERNON ST APT 1
BOSTON MA
02108-1114
US

V. Phone/Fax

Practice location:
  • Phone: 617-636-5000
  • Fax:
Mailing address:
  • Phone: 305-301-4354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number128724
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11005642
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2365040
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: