MEDICARE: MR. MORGAN CHARLES GALBRAITH A.P.R.N.

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	7587493-4405	UT

General Provider Information

NPI Number	:	1285084525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MORGAN CHARLES GALBRAITH A.P.R.N.

Provider Business Mailing Address
First Line	:	813 E 200 S # 1
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-2304
Country	:	US
Telephone Number	:	801-505-1209
Fax Number	:

Provider Business Practice Location Address
First Line	:	813 E 200 S # 1
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-2304
Country	:	US
Telephone Number	:	801-505-1209
Fax Number	:

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

Provider Enumeration Date	:	06/17/2016
Last Update Date	:	06/17/2016

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