Healthcare Provider Details

I. General information

NPI: 1710055421
Provider Name (Legal Business Name): BETHANN MORGAN MSN, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 07/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2185 GALLOWAY RD
BENSALEM PA
19020-2983
US

IV. Provider business mailing address

PO BOX 813
TREXLERTOWN PA
18087-0813
US

V. Phone/Fax

Practice location:
  • Phone: 610-481-0481
  • Fax: 610-481-0486
Mailing address:
  • Phone: 610-481-0481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberRN290438L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberSP002097G
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: