Provider Demographics
NPI:1497041925
Name:MORGAN, VIRLISHA RENA (RN)
Entity Type:Individual
Prefix:MRS
First Name:VIRLISHA
Middle Name:RENA
Last Name:MORGAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8315 N 96TH CT
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224-2774
Mailing Address - Country:US
Mailing Address - Phone:414-446-8793
Mailing Address - Fax:
Practice Address - Street 1:8315 N 96TH CT
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53224-2774
Practice Address - Country:US
Practice Address - Phone:414-418-6868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI155190-30163WN0003X, 163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No163WN0003XNursing Service ProvidersRegistered NurseNeonatal, Low-Risk
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI$$$$$$$$$Medicaid
WI$$$$$$$$$Medicare UPIN
WI$$$$$$$$$Medicare Oscar/Certification
WI$$$$$$$$$Medicare PIN