Basic Information
Provider Information
NPI: 1194441246
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CONFER
FirstName: BROOKE
MiddleName: MORGAN
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7 DOCK HILL RD
Address2:  
City: MIDDLEBURG
State: PA
PostalCode: 178428910
CountryCode: US
TelephoneNumber: 5708372123
FaxNumber: 5708372185
Practice Location
Address1: 145 SHAFFER ST
Address2:  
City: WILLIAMSPORT
State: PA
PostalCode: 177026727
CountryCode: US
TelephoneNumber: 5703271335
FaxNumber: 5703217800
Other Information
ProviderEnumerationDate: 10/19/2022
LastUpdateDate: 10/19/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/30/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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