Provider Demographics
NPI:1811519499
Name:MORSE, ELLEN ANNE (NP-C)
Entity type:Individual
Prefix:
First Name:ELLEN ANNE
Middle Name:
Last Name:MORSE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ELLEN ANNE
Other - Middle Name:
Other - Last Name:GALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:2251 WAGNER LN
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1354
Mailing Address - Country:US
Mailing Address - Phone:732-996-3139
Mailing Address - Fax:
Practice Address - Street 1:2251 WAGNER LN
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1354
Practice Address - Country:US
Practice Address - Phone:732-996-3139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-18
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01033900163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice