Provider Demographics
NPI:1336424332
Name:MORGAN, AMANDA H
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:H
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3380 C ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3949
Mailing Address - Country:US
Mailing Address - Phone:907-277-1440
Mailing Address - Fax:907-277-1436
Practice Address - Street 1:49 MAIN STREET
Practice Address - Street 2:
Practice Address - City:FALSE PASS
Practice Address - State:AK
Practice Address - Zip Code:99583-0049
Practice Address - Country:US
Practice Address - Phone:907-548-2241
Practice Address - Fax:907-548-2247
Is Sole Proprietor?:No
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker