Provider Demographics
NPI:1679234488
Name:BUTTS, MORGAN (DNP, ARNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:
Last Name:BUTTS
Suffix:
Gender:F
Credentials:DNP, ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 LONG AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST JOE
Mailing Address - State:FL
Mailing Address - Zip Code:32456-2208
Mailing Address - Country:US
Mailing Address - Phone:850-340-0041
Mailing Address - Fax:
Practice Address - Street 1:904 E HENRY AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-7143
Practice Address - Country:US
Practice Address - Phone:813-510-5105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11014908363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner