Provider Demographics
NPI:1669822011
Name:MORGAN, JULIE M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:M
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:M
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:146 WILLIAMS DR
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:WV
Mailing Address - Zip Code:25276
Mailing Address - Country:US
Mailing Address - Phone:304-927-8143
Mailing Address - Fax:904-927-8198
Practice Address - Street 1:146 WILLIAMS DR
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:WV
Practice Address - Zip Code:25276
Practice Address - Country:US
Practice Address - Phone:304-927-8143
Practice Address - Fax:904-927-8198
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2768363A00000X
WV1991363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0035046000Medicaid