Provider Demographics
NPI:1639527492
Name:JOLIAT, MORGAN J (MS, CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:J
Last Name:JOLIAT
Suffix:
Gender:F
Credentials:MS, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 LUCKY RD
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-2101
Mailing Address - Country:US
Mailing Address - Phone:518-331-8651
Mailing Address - Fax:
Practice Address - Street 1:7524 MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-7594
Practice Address - Country:US
Practice Address - Phone:518-331-8651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR175008363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health