Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 04-34437 | KS |
NPI | 1295837904 |
---|---|
Provider Name | Jacqueline Michelle Morgan |
First Address | Wichita, KS 67208-3003 |
Second Address | Wichita, KS 67208-3003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 26/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200680090A | (05) | KS |