Provider Demographics
NPI:1740848951
Name:MORGAN, MORGANA LAFAYE (LPN)
Entity type:Individual
Prefix:
First Name:MORGANA
Middle Name:LAFAYE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5394 W RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-1012
Mailing Address - Country:US
Mailing Address - Phone:585-270-9905
Mailing Address - Fax:
Practice Address - Street 1:5394 W RIDGE RD
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-1012
Practice Address - Country:US
Practice Address - Phone:585-270-9905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3337941164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse