Provider Demographics
NPI:1689846644
Name:MORGAN, SHEILA LOUISE (NNP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:LOUISE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730C 14TH ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-4140
Mailing Address - Country:US
Mailing Address - Phone:601-703-9396
Mailing Address - Fax:601-703-9926
Practice Address - Street 1:1730C 14TH ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-4140
Practice Address - Country:US
Practice Address - Phone:601-703-9396
Practice Address - Fax:601-703-9926
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR746366363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS02873070Medicaid