Provider Demographics
NPI:1255195194
Name:MORGAN, ENIOLA OLUBUKONLA (NP)
Entity type:Individual
Prefix:
First Name:ENIOLA
Middle Name:OLUBUKONLA
Last Name:MORGAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ENIOLA
Other - Middle Name:OLUBUKONLA
Other - Last Name:AWOLESI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:479 S 200 W
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3517
Mailing Address - Country:US
Mailing Address - Phone:435-313-1864
Mailing Address - Fax:
Practice Address - Street 1:479 S 200 W
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3517
Practice Address - Country:US
Practice Address - Phone:435-313-1864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10836868-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse