Provider Demographics
NPI:1811223654
Name:MORGAN, ELIZABETH A (FNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:MORGAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:SODERBERG-HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:340 E. BETTERAVIA ROAD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454
Mailing Address - Country:US
Mailing Address - Phone:805-922-0561
Mailing Address - Fax:805-922-0083
Practice Address - Street 1:340 E. BETTERAVIA ROAD
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454
Practice Address - Country:US
Practice Address - Phone:805-922-0561
Practice Address - Fax:805-922-0083
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10112363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q06318Medicare UPIN