Individual
MRS. MORGAN ELIZABETH GRACE SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 556-7704
(573) 556-1714
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
(573) 556-5771
(573) 636-9756
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2017030714
MO
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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