MEDICARE: MORGAN HARRISON FNP-C

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	363L00000X	Nurse Practitioner	340111	AZ

General Provider Information

NPI Number	:	1548192438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN HARRISON FNP-C

Provider Business Mailing Address
First Line	:	11754 MORENO AVE
Second Line	:
City	:	LAKESIDE
State	:	CA
Zip	:	92040-1109
Country	:	US
Telephone Number	:	847-977-5536
Fax Number	:

Provider Business Practice Location Address
First Line	:	1850 MCCULLOCH BLVD N STE C1
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-5798
Country	:	US
Telephone Number	:	847-977-5536
Fax Number	:

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

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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