=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457711871
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINNA MORGAN NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2016
-----------------------------------------------------
Last Update Date | 03/06/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5150 E MAIN ST STE 102105
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43213-2441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-328-5555
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 424 S COLUMBIA AVE
-----------------------------------------------------
City | BEXLEY
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43209-1629
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-778-1608
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | COA.18603-NP
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------