Healthcare Provider Details

I. General information

NPI: 1467775320
Provider Name (Legal Business Name): MORGAN ELISE SHARLOW RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2010
Last Update Date: 03/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 E CAMPUS MALL
MADISON WI
53715-1365
US

IV. Provider business mailing address

6748 JACOBS WAY APT 4
MADISON WI
53711-3293
US

V. Phone/Fax

Practice location:
  • Phone: 608-890-3343
  • Fax:
Mailing address:
  • Phone: 920-723-8043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number166476-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: