Provider Demographics
NPI:1538656491
Name:TEVLIN, MORGAN (ANP)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:TEVLIN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 N CASCADE AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6265
Mailing Address - Country:US
Mailing Address - Phone:719-636-1201
Mailing Address - Fax:719-955-0986
Practice Address - Street 1:2920 N CASCADE AVE STE 301
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6265
Practice Address - Country:US
Practice Address - Phone:719-636-1201
Practice Address - Fax:719-955-0986
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0993743-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner