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General NPI Number Information
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NPI Number | 1164940557
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Entity Type | Individual
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Provider Name | SHANNON MORGENSTERN NP
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Gender | Female
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Dates
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Enumeration Date | 09/06/2017
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | M.L. MEDSPA 1643 N. ALVERNON WAY #103
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City | TUCSON
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State | AZ
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Zip | 85712
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Country | US
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Telephone | 520-991-7344
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Fax |
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Provider Business Mailing Address
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Address Line | 5055 E BROADWAY BLVD STE A100
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City | TUCSON
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State | AZ
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Zip | 85711-3629
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Country | US
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Telephone | 520-382-1205
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Fax | 520-795-0225
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP10557
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License Number State | AZ
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