Provider Demographics
NPI:1073163028
Name:MORGAN, VICKI LYNN (CRNP)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:LYNN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 MCCLELLANDTOWN RD
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-3107
Mailing Address - Country:US
Mailing Address - Phone:724-366-8664
Mailing Address - Fax:
Practice Address - Street 1:289 MCCLELLANDTOWN RD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3107
Practice Address - Country:US
Practice Address - Phone:724-439-3627
Practice Address - Fax:724-439-0489
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020765363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily