Provider Demographics
NPI:1376159939
Name:MORNEY-KUANYAWO, MARGARETTE
Entity Type:Individual
Prefix:MRS
First Name:MARGARETTE
Middle Name:
Last Name:MORNEY-KUANYAWO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 S FULLER AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3244
Mailing Address - Country:US
Mailing Address - Phone:661-888-3727
Mailing Address - Fax:
Practice Address - Street 1:515 S FULLER AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3244
Practice Address - Country:US
Practice Address - Phone:661-888-3727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010109363LF0000X
GA156026207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily