Provider Demographics
NPI:1104216662
Name:HANNI, MORGAN (PA-C)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:HANNI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 N OLIE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-7339
Mailing Address - Country:US
Mailing Address - Phone:405-419-5665
Mailing Address - Fax:
Practice Address - Street 1:6600 N OLIE AVE STE C
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-7339
Practice Address - Country:US
Practice Address - Phone:405-419-5665
Practice Address - Fax:405-419-5429
Is Sole Proprietor?:No
Enumeration Date:2015-02-04
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2487363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
.OtherPA-C