Healthcare Provider Details

I. General information

NPI: 1003735218
Provider Name (Legal Business Name): MORGAN ELLEBRECHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N 92ND ST
MILWAUKEE WI
53226-1202
US

IV. Provider business mailing address

9605 W HAMPTON AVE APT 201
WAUWATOSA WI
53225-4062
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22273-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: