Provider Demographics
NPI:1982397352
Name:MORGAN, HEATHER IRMA (RN,IBCLC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:IRMA
Last Name:MORGAN
Suffix:
Gender:F
Credentials:RN,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12863 BIRKENSTOCK ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-7096
Mailing Address - Country:US
Mailing Address - Phone:317-373-1483
Mailing Address - Fax:
Practice Address - Street 1:8770 COMMERCE PARK PL STE E
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-3128
Practice Address - Country:US
Practice Address - Phone:317-572-8392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INL-151670163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant