Provider Demographics
NPI:1215694872
Name:DREXELIUS, MORGAN L (CRNP)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:L
Last Name:DREXELIUS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:LYNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:833 CHESTNUT ST STE 520
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4430
Mailing Address - Country:US
Mailing Address - Phone:267-606-4478
Mailing Address - Fax:267-339-3761
Practice Address - Street 1:234 MALL BLVD STE G30
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2921
Practice Address - Country:US
Practice Address - Phone:800-321-9999
Practice Address - Fax:267-479-1321
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024814363L00000X
PARN535868163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse