Provider Demographics
NPI:1184361339
Name:ROSEGGER, MORGAN ANDREA (PA)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:ANDREA
Last Name:ROSEGGER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 SW 20TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-4020
Mailing Address - Country:US
Mailing Address - Phone:863-669-7293
Mailing Address - Fax:
Practice Address - Street 1:4105 SW 20TH TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-4020
Practice Address - Country:US
Practice Address - Phone:863-669-7293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program