Healthcare Provider Details

I. General information

NPI: 1790033504
Provider Name (Legal Business Name): NICHOLAS MORGAN N.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2012
Last Update Date: 12/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 N CEDAR ST STE 2A
LANSING MI
48906-5334
US

IV. Provider business mailing address

1106 N CEDAR ST SUITE 200A
LANSING MI
48906-5334
US

V. Phone/Fax

Practice location:
  • Phone: 517-455-7455
  • Fax: 517-940-4372
Mailing address:
  • Phone: 517-455-7455
  • Fax: 517-940-4372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number8303602-7100
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: