Healthcare Provider Details

I. General information

NPI: 1033976568
Provider Name (Legal Business Name): MORGAN GELINAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2024
Last Update Date: 03/01/2024
Certification Date: 03/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 W HARRIE ST
NEWBERRY MI
49868-1209
US

IV. Provider business mailing address

W17461 NORTON RD
GOULD CITY MI
49838-9063
US

V. Phone/Fax

Practice location:
  • Phone: 906-293-9200
  • Fax:
Mailing address:
  • Phone: 906-287-0903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704354763
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: