Healthcare Provider Details

I. General information

NPI: 1821492802
Provider Name (Legal Business Name): MORGAN ZAVADIL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2014
Last Update Date: 12/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N 37TH ST STE 103
NORFOLK NE
68701-3283
US

IV. Provider business mailing address

110 N 37TH ST STE 103
NORFOLK NE
68701-3283
US

V. Phone/Fax

Practice location:
  • Phone: 402-316-3250
  • Fax: 402-316-3250
Mailing address:
  • Phone: 402-316-3250
  • Fax: 402-316-3250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: