Provider Demographics
NPI:1508642273
Name:ALLEN, MORGAN (,FNP-BC)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
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 1:400 S CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MS
Mailing Address - Zip Code:39730-3335
Mailing Address - Country:US
Mailing Address - Phone:662-369-2455
Mailing Address - Fax:
Practice Address - Street 1:400 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MS
Practice Address - Zip Code:39730-3335
Practice Address - Country:US
Practice Address - Phone:662-369-2455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906250363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily