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General NPI Number Information
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NPI Number | 1649375098
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Entity Type | Individual
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Provider Name | AMANDA V MORGAN PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 03/02/2017
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Provider Practice Location Address
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Address Line | 551 LINN ST
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City | ALLEGAN
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State | MI
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Zip | 49010-1595
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Country | US
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Telephone | 269-686-5800
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Fax | 269-686-5896
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Provider Business Mailing Address
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Address Line | 5717 OAKLAND DR STE A
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City | PORTAGE
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State | MI
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Zip | 49024-1116
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Country | US
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Telephone | 269-323-4473
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Fax | 269-324-0755
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601004617
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License Number State | MI
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