Provider Demographics
NPI:1457908501
Name:JOKIEL, MORGANA LISA (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MORGANA
Middle Name:LISA
Last Name:JOKIEL
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 1:5310 HOMESTEAD RD NE BLDG 4
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-1524
Mailing Address - Country:US
Mailing Address - Phone:505-256-3648
Mailing Address - Fax:
Practice Address - Street 1:5310 HOMESTEAD RD NE BLDG 4
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1524
Practice Address - Country:US
Practice Address - Phone:505-256-3648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM57387207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine