Healthcare Provider Details

I. General information

NPI: 1104746114
Provider Name (Legal Business Name): MS. MORGAN ELIZABETH STUTTS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 S 5TH ST FL 5
COLUMBIA MO
65211-6203
US

IV. Provider business mailing address

1 STUYVESANT OVAL APT TG
NEW YORK NY
10009-2140
US

V. Phone/Fax

Practice location:
  • Phone: 760-840-7324
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: