MEDICARE: EMMA NICOLE MORGAN

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	390200000X	Student in an Organized Health Care Education/Training Program	60968304	WA

General Provider Information

NPI Number	:	1447869326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMA NICOLE MORGAN

Provider Business Mailing Address
First Line	:	6614 SUNNYSLOPE RD SW
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98367-9142
Country	:	US
Telephone Number	:	360-536-6316
Fax Number	:

Provider Business Practice Location Address
First Line	:	6614 SUNNYSLOPE RD SW
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98367-9142
Country	:	US
Telephone Number	:	360-536-6316
Fax Number	:

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

Provider Enumeration Date	:	07/27/2020
Last Update Date	:	07/27/2020

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Directions to “ EMMA NICOLE MORGAN ” Practice Location

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