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General NPI Number Information
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NPI Number | 1033307780
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Entity Type | Individual
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Provider Name | JUSTINE HOLLE MORGAN CFNP
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Gender | Female
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 12/08/2020
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Provider Practice Location Address
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Address Line | 415 N 9TH ST SUITE 2W106
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City | SPRINGFIELD
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State | IL
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Zip | 62702
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Country | US
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Telephone | 217-545-7377
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Fax | 217-545-7021
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Provider Business Mailing Address
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Address Line | PO BOX 19678
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City | SPRINGFIELD
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State | IL
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Zip | 62794-9678
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Country | US
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Telephone | 217-545-7377
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Fax | 217-545-7021
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209-006692
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 364SX0204X
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Taxonomy Name | Pediatric Oncology Clinical Nurse Specialist
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License Number | 209-006692
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License Number State | IL
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