Provider Demographics
NPI:1912121682
Name:MORNINGSTAR, SUE MAUER (NP)
Entity Type:Individual
Prefix:MS
First Name:SUE
Middle Name:MAUER
Last Name:MORNINGSTAR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1682
Mailing Address - Country:US
Mailing Address - Phone:541-482-2032
Mailing Address - Fax:541-482-4108
Practice Address - Street 1:534 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1682
Practice Address - Country:US
Practice Address - Phone:541-482-2032
Practice Address - Fax:541-482-4108
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory