Provider Demographics
NPI:1831789882
Name:MORGAN, JACKIE K (ARNP)
Entity type:Individual
Prefix:
First Name:JACKIE
Middle Name:K
Last Name:MORGAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 138
Mailing Address - Street 2:
Mailing Address - City:KEOTA
Mailing Address - State:IA
Mailing Address - Zip Code:52248-0138
Mailing Address - Country:US
Mailing Address - Phone:319-383-7044
Mailing Address - Fax:833-740-3624
Practice Address - Street 1:302 E BROADWAY AVE
Practice Address - Street 2:PO BOX 138
Practice Address - City:KEOTA
Practice Address - State:IA
Practice Address - Zip Code:52248
Practice Address - Country:US
Practice Address - Phone:319-383-7044
Practice Address - Fax:833-740-3624
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-24
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA161562363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily