Individual
MRS. MORGAN LANGE HENNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, ATC
Contact information
Practice address
3200 E RACINE ST, JANESVILLE, WI 53546-2343
(608) 371-8000
(608) 371-8932
Mailing address
4298 RAYMIR CIR, WAUWATOSA, WI 53222-1140
(608) 444-6704
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
Primary
4379
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942699632
—
WI
Enumeration date
01/18/2015
Last updated
08/20/2024
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