Provider Demographics
NPI:1902380785
Name:CRAFT, MORGAN (PA-C)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:CRAFT
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 1:3591 RESERVOIR RD
Mailing Address - Street 2:
Mailing Address - City:HELLERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18055-2007
Mailing Address - Country:US
Mailing Address - Phone:570-419-8191
Mailing Address - Fax:
Practice Address - Street 1:185 ROSEBERRY ST
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1690
Practice Address - Country:US
Practice Address - Phone:908-847-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA060122363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA060122OtherMEDICAL LICENSE NUMBER