Provider Demographics
NPI:1699042754
Name:MORGAN, MELISSA BEARDEN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:BEARDEN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2668 HARPER RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834
Mailing Address - Country:US
Mailing Address - Phone:662-287-7138
Mailing Address - Fax:662-287-7157
Practice Address - Street 1:2668 S HARPER RD
Practice Address - Street 2:SUITE 1
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-6770
Practice Address - Country:US
Practice Address - Phone:662-287-7138
Practice Address - Fax:662-287-7157
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR857078363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care