Provider Demographics
NPI:1134239023
Name:MORGAN, LAURIE D (CNM)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:D
Last Name:MORGAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:D
Other - Last Name:HERSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9213 UNIVERSITY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9145
Mailing Address - Country:US
Mailing Address - Phone:843-572-7123
Mailing Address - Fax:843-818-1126
Practice Address - Street 1:171 ASHLEY AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-9145
Practice Address - Country:US
Practice Address - Phone:843-792-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3960367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCMW0195Medicaid