Provider Demographics
NPI:1629019633
Name:MORGAN, GERTRUDE A (CFNP)
Entity Type:Individual
Prefix:MS
First Name:GERTRUDE
Middle Name:A
Last Name:MORGAN
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1988
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41702
Mailing Address - Country:US
Mailing Address - Phone:606-439-1300
Mailing Address - Fax:606-439-1400
Practice Address - Street 1:145 CITIZENS LANE
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701
Practice Address - Country:US
Practice Address - Phone:606-439-1300
Practice Address - Fax:606-439-1400
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY582P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78000569Medicaid
183947Medicare Oscar/Certification
0776317Medicare PIN
183953Medicare Oscar/Certification
183918Medicare Oscar/Certification
183942Medicare Oscar/Certification
R38197Medicare UPIN
KY78000569Medicaid
KY00712002Medicare PIN