Healthcare Provider Details

I. General information

NPI: 1184350894
Provider Name (Legal Business Name): MORGAN TAYLOR NELSON DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MORGAN MCCUEN

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 CORPORATE DR
BEAVER DAM WI
53916-3115
US

IV. Provider business mailing address

250 CORPORATE DR
BEAVER DAM WI
53916-3115
US

V. Phone/Fax

Practice location:
  • Phone: 920-887-7156
  • Fax:
Mailing address:
  • Phone: 920-887-7156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15913-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: