Provider Demographics
NPI:1750864823
Name:MORGAN, CHRISETTIA B (APRN, DNP, FNP-C)
Entity type:Individual
Prefix:
First Name:CHRISETTIA
Middle Name:B
Last Name:MORGAN
Suffix:
Gender:F
Credentials:APRN, DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5507 E. EVANS RD STE 104
Mailing Address - Street 2:BOX 119
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78261-2233
Mailing Address - Country:US
Mailing Address - Phone:210-323-3712
Mailing Address - Fax:
Practice Address - Street 1:24619 AHAVA
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78261-2233
Practice Address - Country:US
Practice Address - Phone:682-352-2984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-13
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF09180344207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine