Provider Demographics
NPI:1689717829
Name:BOYD-MORRISON, SHAWNNA (NP)
Entity Type:Individual
Prefix:MRS
First Name:SHAWNNA
Middle Name:
Last Name:BOYD-MORRISON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 RUE VERTE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5205
Mailing Address - Country:US
Mailing Address - Phone:949-722-2510
Mailing Address - Fax:949-722-2511
Practice Address - Street 1:2077 HARBOR BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-2630
Practice Address - Country:US
Practice Address - Phone:949-722-2510
Practice Address - Fax:949-722-2511
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA467523363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health