Provider Demographics
NPI:1699382176
Name:PREJEAN, MORGAN (PA-C)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:PREJEAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38200 S LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-8300
Mailing Address - Country:US
Mailing Address - Phone:225-276-3380
Mailing Address - Fax:
Practice Address - Street 1:11445 COURSEY BLVD STE L
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-0411
Practice Address - Country:US
Practice Address - Phone:225-273-8988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA324529363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical