Provider Demographics
NPI:1053709857
Name:MORGAN, KORI ANN (CRNP)
Entity type:Individual
Prefix:MISS
First Name:KORI
Middle Name:ANN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 SIR THOMAS CT FL 1
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-4839
Mailing Address - Country:US
Mailing Address - Phone:717-988-0020
Mailing Address - Fax:717-703-5746
Practice Address - Street 1:805 SIR THOMAS CT
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4839
Practice Address - Country:US
Practice Address - Phone:717-988-0020
Practice Address - Fax:717-703-5746
Is Sole Proprietor?:No
Enumeration Date:2014-12-31
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014369363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103047774Medicaid
PA390901Medicare PIN