Healthcare Provider Details

I. General information

NPI: 1376095331
Provider Name (Legal Business Name): MORGAN PAIGE JOHNS APRN-CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 06/28/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 S PARK LN
ALTUS OK
73521-5753
US

IV. Provider business mailing address

1200 E PECAN ST
ALTUS OK
73521-6192
US

V. Phone/Fax

Practice location:
  • Phone: 580-379-6500
  • Fax: 580-379-6509
Mailing address:
  • Phone: 580-379-5000
  • Fax: 580-379-5509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number109572
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: