Provider Demographics
NPI:1518399393
Name:MORGAN, KEVIN (FNP)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:MORGAN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 NEDERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-2832
Mailing Address - Country:US
Mailing Address - Phone:409-221-8294
Mailing Address - Fax:409-344-9592
Practice Address - Street 1:3717 ROYAL MEADOWS ST
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-6869
Practice Address - Country:US
Practice Address - Phone:409-722-0600
Practice Address - Fax:409-724-1928
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX758246363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily