Provider Demographics
NPI:1790586543
Name:MORGAN, JOHN A (RN)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:A
Last Name:MORGAN
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12240 KILLDEER ST NW APT 1203
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55448-7568
Mailing Address - Country:US
Mailing Address - Phone:608-630-5767
Mailing Address - Fax:
Practice Address - Street 1:1020 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-2504
Practice Address - Country:US
Practice Address - Phone:612-895-3850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ229480163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health