Provider Demographics
NPI:1215364674
Name:MORGAN, NATHAN DEVEARL (PA-C)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:DEVEARL
Last Name:MORGAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 N NAPPANEE ST
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-1957
Mailing Address - Country:US
Mailing Address - Phone:574-522-0265
Mailing Address - Fax:574-293-2855
Practice Address - Street 1:6460 MEDICAL CENTER ST STE 350
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-2423
Practice Address - Country:US
Practice Address - Phone:702-255-6647
Practice Address - Fax:702-933-1444
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2019-05-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN10001466A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant