Provider Demographics
NPI:1831501204
Name:KUCALA, MORGAN (CNP)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:KUCALA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20029 JANUARY ST
Mailing Address - Street 2:
Mailing Address - City:BIG LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55309-4829
Mailing Address - Country:US
Mailing Address - Phone:712-260-2672
Mailing Address - Fax:
Practice Address - Street 1:20029 JANUARY ST
Practice Address - Street 2:
Practice Address - City:BIG LAKE
Practice Address - State:MN
Practice Address - Zip Code:55309-4829
Practice Address - Country:US
Practice Address - Phone:712-260-2672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-20
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10921363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner