Provider Demographics
NPI:1619643103
Name:BRANDON, MORGAN ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:ELIZABETH
Last Name:BRANDON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 N DESLOGE DR
Mailing Address - Street 2:
Mailing Address - City:DESLOGE
Mailing Address - State:MO
Mailing Address - Zip Code:63601-2936
Mailing Address - Country:US
Mailing Address - Phone:573-431-6677
Mailing Address - Fax:
Practice Address - Street 1:1025 MO-72
Practice Address - Street 2:
Practice Address - City:FREDERICKTOWN
Practice Address - State:MO
Practice Address - Zip Code:63645
Practice Address - Country:US
Practice Address - Phone:573-783-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021028725183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist