Provider Demographics
NPI:1497047971
Name:MORGAN, KIMKESHIA NESHELL (CRNP)
Entity Type:Individual
Prefix:MS
First Name:KIMKESHIA
Middle Name:NESHELL
Last Name:MORGAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:KIMKESHIA
Other - Middle Name:NESHELL
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:140 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:GILBERTOWN
Mailing Address - State:AL
Mailing Address - Zip Code:36908-5510
Mailing Address - Country:US
Mailing Address - Phone:251-276-2944
Mailing Address - Fax:
Practice Address - Street 1:140 FRONT ST
Practice Address - Street 2:
Practice Address - City:GILBERTOWN
Practice Address - State:AL
Practice Address - Zip Code:36908-5510
Practice Address - Country:US
Practice Address - Phone:251-276-2944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-089677363L00000X, 363LA2200X
MSR860733363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03731501Medicaid
AL130709Medicaid
AL130709Medicaid
AL1025010634Medicare NSC