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General NPI Number Information
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NPI Number | 1437381209
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Entity Type | Individual
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Provider Name | MARY M. MORGAN NP
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Gender | Female
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Dates
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Enumeration Date | 08/12/2009
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 1660 WOODSAGE AVE, BLDG A
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City | MERRIDIAN
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State | ID
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Zip | 83642
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Country | US
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Telephone | 208-906-1231
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Fax | 208-906-1232
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Provider Business Mailing Address
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Address Line | 1160 WOODSAGE AVENUE BLDG A
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City | MERIDIAN
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State | ID
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Zip | 83642
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Country | US
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Telephone | 208-906-1231
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Fax | 208-906-1232
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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 | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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License Number | 20407A
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP-937A
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License Number State | ID
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