Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 11262383-1205 | UT |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | M-15823 | ID |
NPI | 1073871042 |
---|---|
Provider Name | Dr. Ashley Eleen Morgan |
First Address | Boise, ID 83712-6241 |
Second Address | Boise, ID 83702-6132 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2012 |
Last Update Date | 27/10/2021 |