Healthcare Provider Details

I. General information

NPI: 1851110753
Provider Name (Legal Business Name): COURTNEY ANN MORGAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 10/08/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17162 DUNE VIEW DR APT 108
GRAND HAVEN MI
49417-7917
US

IV. Provider business mailing address

17162 DUNE VIEW DR APT 108
GRAND HAVEN MI
49417-7917
US

V. Phone/Fax

Practice location:
  • Phone: 231-726-8201
  • Fax:
Mailing address:
  • Phone: 231-726-8201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number4704324172
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number4704324172
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: