Provider Demographics
NPI:1497534788
Name:MORGAN, WESLEY HARRISON (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:WESLEY
Middle Name:HARRISON
Last Name:MORGAN
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 RIDGEWAY DR
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-2426
Mailing Address - Country:US
Mailing Address - Phone:270-217-6421
Mailing Address - Fax:
Practice Address - Street 1:1619 RIDGEWAY DR
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-2426
Practice Address - Country:US
Practice Address - Phone:270-217-6421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023017377363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily