Provider Demographics
NPI:1972650521
Name:PATRICIA ANN MORGAN
Entity type:Organization
Organization Name:PATRICIA ANN MORGAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:REEGT, RPSGT
Authorized Official - Phone:208-772-1417
Mailing Address - Street 1:6088 N COLFAX ST
Mailing Address - Street 2:
Mailing Address - City:DALTON GARDENS
Mailing Address - State:ID
Mailing Address - Zip Code:83815-9283
Mailing Address - Country:US
Mailing Address - Phone:208-772-1417
Mailing Address - Fax:
Practice Address - Street 1:1211 MICHIGAN ST
Practice Address - Street 2:SUITE A
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-5185
Practice Address - Country:US
Practice Address - Phone:208-265-0432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic