Healthcare Provider Details

I. General information

NPI: 1497041925
Provider Name (Legal Business Name): VIRLISHA RENA MORGAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 06/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8315 N 96TH CT
MILWAUKEE WI
53224-2774
US

IV. Provider business mailing address

8315 N 96TH CT
MILWAUKEE WI
53224-2774
US

V. Phone/Fax

Practice location:
  • Phone: 414-418-6868
  • Fax:
Mailing address:
  • Phone: 414-446-8793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0003X
TaxonomyLow-Risk Neonatal Registered Nurse
License Number155190-30
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number155190-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: