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NPI Code Detail

MEDICARE: SUSAN ANNE MORGAN CNM, FNP

MEDICARE:   SUSAN ANNE MORGAN  CNM, FNP
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
1363L00000XNurse Practitioner200250115NPOR
2367A00000XAdvanced Practice Midwife077010025N5OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21407812365OTHERORNBMC NPI NUMBER-GROUP
303-15-2007OTHERORNBMC TERMINATION DATE
493-0635514OTHERORGROUP TAX ID FOR BILLING

General Provider Information

NPI Number : 1962487108
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN ANNE MORGAN CNM, FNP
Provider Business Mailing Address
First Line : 1775 THOMPSON RD.
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2125
Country : US
Telephone Number : 541-269-8538
Fax Number : 541-267-5083
Provider Business Practice Location Address
First Line : 1775 THOMPSON RD.
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2125
Country : US
Telephone Number : 541-269-8538
Fax Number : 541-267-5083
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2005
Last Update Date : 02/22/2012

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Directions to “ SUSAN ANNE MORGAN CNM, FNP” Practice Location

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