Provider Demographics
NPI:1740201193
Name:MORGAN, LEE R (CRNA)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:R
Last Name:MORGAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:LEE
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:2151 OLD ROCKY RIDGE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-7251
Mailing Address - Country:US
Mailing Address - Phone:205-989-1091
Mailing Address - Fax:205-989-1087
Practice Address - Street 1:2720 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-3408
Practice Address - Country:US
Practice Address - Phone:205-989-1091
Practice Address - Fax:205-989-1087
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-041297367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000071589Medicaid
AL430001920OtherMEDICARE RAILROAD
ALR63231Medicare UPIN