MEDICARE: MR. WINDLE HOGUE MORGAN MSN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	13885	TN

General Provider Information

NPI Number	:	1316183148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WINDLE HOGUE MORGAN MSN

Provider Business Mailing Address
First Line	:	223 MADISON ST
Second Line	:	STE 103
City	:	MADISON
State	:	TN
Zip	:	37115-3660
Country	:	US
Telephone Number	:	615-860-0808
Fax Number	:

Provider Business Practice Location Address
First Line	:	223 MADISON ST
Second Line	:	STE 103
City	:	MADISON
State	:	TN
Zip	:	37115-3660
Country	:	US
Telephone Number	:	615-860-0808
Fax Number	:

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

Provider Enumeration Date	:	12/29/2008
Last Update Date	:	03/26/2021

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