Healthcare Provider Details

I. General information

NPI: 1972013381
Provider Name (Legal Business Name): MORGAN PELLEGRINI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2017
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4403 HARRISON BLVD
OGDEN UT
84403-3271
US

IV. Provider business mailing address

6874 S COOK DR
SOUTH WEBER UT
84405-7199
US

V. Phone/Fax

Practice location:
  • Phone: 801-387-8350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6956
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: