Healthcare Provider Details

I. General information

NPI: 1619463502
Provider Name (Legal Business Name): REBECCA L MORLEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2018
Last Update Date: 03/10/2021
Certification Date: 03/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MCGREGOR ST
MANCHESTER NH
03102
US

IV. Provider business mailing address

100 MCGREGOR ST
MANCHESTER NH
03102-3770
US

V. Phone/Fax

Practice location:
  • Phone: 603-668-3545
  • Fax:
Mailing address:
  • Phone: 603-668-3545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number067798-21
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number067798-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: