Basic Information
Provider Information
NPI: 1003151853
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORGAN
FirstName: SHARLA
MiddleName:  
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Credential:  
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Mailing Information
Address1: 1055 N 300 W
Address2: STE 401
City: PROVO
State: UT
PostalCode: 846043306
CountryCode: US
TelephoneNumber: 8013561300
FaxNumber: 8013561304
Practice Location
Address1: 1055 N 300 W
Address2: SUITE 212
City: PROVO
State: UT
PostalCode: 846043344
CountryCode: US
TelephoneNumber: 8013561300
FaxNumber: 8013561304
Other Information
ProviderEnumerationDate: 12/05/2012
LastUpdateDate: 09/05/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X5880189-4405UTY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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