Basic Information
| Provider Information | |||||||||
| NPI: | 1508352840 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FISCHER | ||||||||
| FirstName: | MORGAN | ||||||||
| MiddleName: | |||||||||
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| Credential: | OT | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | OCKINGA | ||||||||
| OtherFirstName: | MORGAN | ||||||||
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| OtherCredential: | OT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 5285 | ||||||||
| Address2: | |||||||||
| City: | GRAND ISLAND | ||||||||
| State: | NE | ||||||||
| PostalCode: | 688025285 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3083820344 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3601 CIMARRON PLZ STE 100 | ||||||||
| Address2: | |||||||||
| City: | HASTINGS | ||||||||
| State: | NE | ||||||||
| PostalCode: | 689012883 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024632077 | ||||||||
| FaxNumber: | 4024632062 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2018 | ||||||||
| LastUpdateDate: | 10/18/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 2215 | NE | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.