Healthcare Provider Details

I. General information

NPI: 1609713957
Provider Name (Legal Business Name): MORGAN NEVAEH WYNN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 E A ST
HASTINGS NE
68901-6201
US

IV. Provider business mailing address

126 E A ST
HASTINGS NE
68901-6201
US

V. Phone/Fax

Practice location:
  • Phone: 402-831-7257
  • Fax:
Mailing address:
  • Phone: 402-831-7257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: