Provider Demographics
NPI:1982141925
Name:MORGAN, AMANDA MARY
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:MARY
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:MARY
Other - Last Name:SLAVINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:255 GALEN HALL RD
Mailing Address - Street 2:
Mailing Address - City:REINHOLDS
Mailing Address - State:PA
Mailing Address - Zip Code:17569-9572
Mailing Address - Country:US
Mailing Address - Phone:814-558-8731
Mailing Address - Fax:
Practice Address - Street 1:1 LONGSDORF WAY
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-7623
Practice Address - Country:US
Practice Address - Phone:717-245-9941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-29
Last Update Date:2017-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program