Healthcare Provider Details

I. General information

NPI: 1851707814
Provider Name (Legal Business Name): MORGAN KRISTA SHASTEEN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MORGAN SHASTEEN APRN, NP-C

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 01/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 HILYARD ST
EUGENE OR
97401-3718
US

IV. Provider business mailing address

1255 HILYARD ST
EUGENE OR
97401-3718
US

V. Phone/Fax

Practice location:
  • Phone: 541-686-7300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number201603832NP-PP
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number201603832NP-PP
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number201603832NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: