Healthcare Provider Details

I. General information

NPI: 1508996091
Provider Name (Legal Business Name): SALLY W. MORGAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 03/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 W 10TH AVE S761 RHODES HALL, OSU MEDICAL CENTER
COLUMBUS OH
43210-1240
US

IV. Provider business mailing address

410 W 10TH AVE S761 RHODES
COLUMBUS OH
43210-1240
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-7286
  • Fax: 614-293-9037
Mailing address:
  • Phone: 614-293-7286
  • Fax: 614-293-9037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number153460
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRNCNP02235
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: