MEDICARE: MORGAN WASSEL FNP-BC

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	363LF0000X	Family Nurse Practitioner	1003134	TX

General Provider Information

NPI Number	:	1093304909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN WASSEL FNP-BC

Provider Business Mailing Address
First Line	:	823 CONGRESS AVE STE 125
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-2435
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	823 CONGRESS AVE STE 125
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-2435
Country	:	US
Telephone Number	:	512-229-1533
Fax Number	:

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

Provider Enumeration Date	:	01/14/2021
Last Update Date	:	01/14/2021

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Directions to “ MORGAN WASSEL FNP-BC” Practice Location

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