MEDICARE: MORGAN HOLM

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	163W00000X	Registered Nurse	RN.427211	OH
2	163W00000X	Registered Nurse	RN.267326	AZ
3	363LA2100X	Acute Care Nurse Practitioner	APRN.CNP.0027122	OH
4	363LA2100X	Acute Care Nurse Practitioner	RNP.267326	AZ

General Provider Information

NPI Number	:	1972107308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN HOLM

Provider Business Mailing Address
First Line	:	7266 E 37TH PL
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85365-1409
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	284 W 32ND ST
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-8152
Country	:	US
Telephone Number	:	928-341-4563
Fax Number	:

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

Provider Enumeration Date	:	11/25/2020
Last Update Date	:	12/16/2021

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Directions to “ MORGAN HOLM ” Practice Location

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