Provider Demographics
NPI:1053177246
Name:WASCHOW, MORGAN NICOLE (PA)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:NICOLE
Last Name:WASCHOW
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:S89W35211 EAGLE TER
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:WI
Mailing Address - Zip Code:53119-2306
Mailing Address - Country:US
Mailing Address - Phone:262-470-7900
Mailing Address - Fax:
Practice Address - Street 1:S89W35211 EAGLE TER
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:WI
Practice Address - Zip Code:53119-2306
Practice Address - Country:US
Practice Address - Phone:262-470-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant