Provider Demographics
NPI:1750610879
Name:MORGAN, KELI J
Entity type:Individual
Prefix:
First Name:KELI
Middle Name:J
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 1:133 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:WY
Mailing Address - Zip Code:82930-4761
Mailing Address - Country:US
Mailing Address - Phone:307-789-0891
Mailing Address - Fax:
Practice Address - Street 1:133 SHADY LN
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:WY
Practice Address - Zip Code:82930-4761
Practice Address - Country:US
Practice Address - Phone:307-789-0891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-19
Last Update Date:2009-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator