Healthcare Provider Details

I. General information

NPI: 1821694712
Provider Name (Legal Business Name): LORI ANN MORGAN RPH, BCGP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2020
Last Update Date: 12/07/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1914 N ALDERS CT
SPRINGFIELD MO
65802-7205
US

IV. Provider business mailing address

1914 N ALDERS CT
SPRINGFIELD MO
65802-7205
US

V. Phone/Fax

Practice location:
  • Phone: 417-793-1486
  • Fax:
Mailing address:
  • Phone: 417-793-1486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number43861
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: