Provider Demographics
NPI:1912558073
Name:PEDERSEN, MORGAN (ARNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:PEDERSEN
Suffix:
Gender:F
Credentials:ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3955 TOPAZ CT
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-6041
Mailing Address - Country:US
Mailing Address - Phone:406-594-3123
Mailing Address - Fax:
Practice Address - Street 1:501 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-2865
Practice Address - Country:US
Practice Address - Phone:406-449-5796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-20
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT146584363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily