MEDICARE: NICOLE E MORGAN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	085.008675	IL
2	363A00000X	Physician Assistant	10987	AZ

General Provider Information

NPI Number	:	1053085779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE E MORGAN PA-C

Provider Business Mailing Address
First Line	:	2145 E BASELINE RD STE 104
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85283-1546
Country	:	US
Telephone Number	:	602-349-8117
Fax Number	:

Provider Business Practice Location Address
First Line	:	2145 E BASELINE RD STE 104
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85283-1546
Country	:	US
Telephone Number	:	602-349-8117
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2021
Last Update Date	:	03/27/2025

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Directions to “ NICOLE E MORGAN PA-C” Practice Location

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