Provider Demographics
NPI:1225885486
Name:OPASANYAH, MORGAN (RN)
Entity type:Individual
Prefix:MR
First Name:MORGAN
Middle Name:
Last Name:OPASANYAH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16015 BLACK WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46040-8818
Mailing Address - Country:US
Mailing Address - Phone:317-987-0900
Mailing Address - Fax:
Practice Address - Street 1:16015 BLACK WILLOW LN
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46040-8818
Practice Address - Country:US
Practice Address - Phone:317-987-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28288411A163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice