Provider Demographics
NPI:1689280620
Name:MORGAN, DANNA RAE (NP)
Entity Type:Individual
Prefix:
First Name:DANNA
Middle Name:RAE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 N BARNEBURG RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6678
Mailing Address - Country:US
Mailing Address - Phone:541-282-4383
Mailing Address - Fax:
Practice Address - Street 1:761 GOLF VIEW DR
Practice Address - Street 2:UNIT C
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-9655
Practice Address - Country:US
Practice Address - Phone:541-326-4294
Practice Address - Fax:541-359-4018
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202007450NP-PP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner