Provider Demographics
NPI:1891976361
Name:MORGAN, CHERI LYNNE (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:CHERI
Middle Name:LYNNE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 HIGHWAY 142
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-8159
Mailing Address - Country:US
Mailing Address - Phone:573-598-8733
Mailing Address - Fax:573-312-3767
Practice Address - Street 1:725 HIGHWAY 142
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-8159
Practice Address - Country:US
Practice Address - Phone:573-598-8733
Practice Address - Fax:573-312-3767
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO128139163W00000X
MORN 128139363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1891976361Medicaid
MOMA2028019Medicare PIN
MOMA2027017Medicare PIN
MO137740025Medicare PIN