Provider Demographics
NPI:1659846921
Name:DEAN, MORGAN TODD (CRNP)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:TODD
Last Name:DEAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:MICHELLE
Other - Last Name:TODD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15243 GREENFIELD DR STE A
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35613-2899
Mailing Address - Country:US
Mailing Address - Phone:256-262-5700
Mailing Address - Fax:256-262-5710
Practice Address - Street 1:15243 GREENFIELD DR STE A
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35613-2899
Practice Address - Country:US
Practice Address - Phone:256-262-5700
Practice Address - Fax:256-262-5710
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-149239363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health