Healthcare Provider Details

I. General information

NPI: 1831831593
Provider Name (Legal Business Name): ALEXANDRA EVELYN MORGAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 04/12/2022
Certification Date: 04/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1393 E SEGO LILY DR
SANDY UT
84092-4350
US

IV. Provider business mailing address

10821 N HIDEOUT CV
HIDEOUT UT
84036-9379
US

V. Phone/Fax

Practice location:
  • Phone: 801-619-9000
  • Fax:
Mailing address:
  • Phone: 985-705-5546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11860023-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: