Provider Demographics
NPI:1487653846
Name:MORGAN, BELINDA R (FNPC)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:R
Last Name:MORGAN
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 FRED MORGAN SR RD
Mailing Address - Street 2:
Mailing Address - City:TALLULAH
Mailing Address - State:LA
Mailing Address - Zip Code:71282-6068
Mailing Address - Country:US
Mailing Address - Phone:318-574-4964
Mailing Address - Fax:
Practice Address - Street 1:2913 BETIN AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7257
Practice Address - Country:US
Practice Address - Phone:318-388-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP03319363LF0000X
LARN 032573 AP03319363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1544060Medicaid
LA1544060Medicaid
LA5X584Medicare ID - Type Unspecified