Provider Demographics
NPI:1104985308
Name:MORGAN, JESSICA ANN (APNP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ANN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-2507
Mailing Address - Country:US
Mailing Address - Phone:414-277-4555
Mailing Address - Fax:
Practice Address - Street 1:1245 N BROADWAY
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2507
Practice Address - Country:US
Practice Address - Phone:414-277-4555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR156626-8363LF0000X
WI5371-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI363LP2300XMedicaid
MN500003608Medicare PIN
MNP00380666Medicare PIN
MNQ73783Medicare UPIN
MN888492000Medicaid
MN500003607Medicare PIN