Healthcare Provider Details

I. General information

NPI: 1376366088
Provider Name (Legal Business Name): MORGAN MARIE SEGRIN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2024
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 W LANCASTER AVE
PAOLI PA
19301-1763
US

IV. Provider business mailing address

1578 HIGHPOINT LN
ASTON PA
19014-1017
US

V. Phone/Fax

Practice location:
  • Phone: 484-565-1000
  • Fax:
Mailing address:
  • Phone: 864-430-4814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number26NR24920500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN672773
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberL1-0053876
License Number StateDE
# 4
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number152567
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: