MEDICARE: MORGAN ERWIN FAMILY NURSE PRACTIT

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	209.030473	IL

General Provider Information

NPI Number	:	1366277519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN ERWIN FAMILY NURSE PRACTIT

Provider Business Mailing Address
First Line	:	1701 E COLLEGE AVE
Second Line	:	INTERNAL MEDICINE
City	:	BLOOMINGTON
State	:	IL
Zip	:	61704
Country	:	US
Telephone Number	:	309-664-3120
Fax Number	:	309-664-3811

Provider Business Practice Location Address
First Line	:	1701 E. COLLEGE AVE
Second Line	:	INTERNAL MEDICINE
City	:	BLOOMINGTON
State	:	IL
Zip	:	61704-2101
Country	:	US
Telephone Number	:	309-664-3120
Fax Number	:	309-664-3811

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

Provider Enumeration Date	:	09/06/2024
Last Update Date	:	02/10/2026

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