Provider Demographics
NPI:1669148219
Name:GILHOUSEN, MORGAN L (PA-C)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:L
Last Name:GILHOUSEN
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 1:82 TOWN RUN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRMOUNT CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16224-1502
Mailing Address - Country:US
Mailing Address - Phone:833-684-1904
Mailing Address - Fax:
Practice Address - Street 1:100 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1440
Practice Address - Country:US
Practice Address - Phone:814-371-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA062749363A00000X
PAOA005763363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant