Healthcare Provider Details

I. General information

NPI: 1770031593
Provider Name (Legal Business Name): SUMMER D. MORGAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUMMER D ABTS NP

II. Dates (important events)

Enumeration Date: 09/21/2016
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MERCY WAY STE 510
JOPLIN MO
64804-4524
US

IV. Provider business mailing address

100 MERCY WAY STE 510
JOPLIN MO
64804-4524
US

V. Phone/Fax

Practice location:
  • Phone: 417-347-4000
  • Fax: 417-347-4064
Mailing address:
  • Phone: 417-623-6056
  • Fax: 417-556-8331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number155319
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2016034608
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number155319
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: