Basic Information
| Provider Information | |||||||||
| NPI: | 1902869118 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORGAN | ||||||||
| FirstName: | JAN | ||||||||
| MiddleName: | SUZANNE | ||||||||
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| Credential: | A.R.N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2601 CHERRY AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | BREMERTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983104203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604159110 | ||||||||
| FaxNumber: | 3604790265 | ||||||||
| Practice Location | |||||||||
| Address1: | 2601 CHERRY AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | BREMERTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983104203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604159110 | ||||||||
| FaxNumber: | 3604790265 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2006 | ||||||||
| LastUpdateDate: | 09/01/2009 | ||||||||
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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 | 363LF0000X | ARNP3059512 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LA2200X | AP 30007519 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.