Provider Demographics
NPI:1669854501
Name:MORNAN, ADENIEKI (MD)
Entity Type:Individual
Prefix:
First Name:ADENIEKI
Middle Name:
Last Name:MORNAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 W PIERCE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-3518
Mailing Address - Country:US
Mailing Address - Phone:575-885-0995
Mailing Address - Fax:
Practice Address - Street 1:2420 W PIERCE ST STE 200
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-3518
Practice Address - Country:US
Practice Address - Phone:575-885-0995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-28
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NMMD2019-0573207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program