Provider Demographics
NPI:1710594908
Name:ZURBORG, MORGAN DANIELLE (PA-C)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:DANIELLE
Last Name:ZURBORG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 TWIN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-2765
Mailing Address - Country:US
Mailing Address - Phone:951-332-1691
Mailing Address - Fax:
Practice Address - Street 1:105 TWIN OAKS DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-2765
Practice Address - Country:US
Practice Address - Phone:951-332-1691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025622363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant