Individual
LAURIE A. MORGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085002139
IL
363AS0400X
Surgical Physician Assistant
Primary
085-002139
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01130125
RR MEDICARE
IL
Enumeration date
08/03/2005
Last updated
09/03/2024
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