Provider Demographics
NPI:1780440529
Name:LAPORTE, MORGAN REED (CRNA)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:REED
Last Name:LAPORTE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:REED
Other - Last Name:LEEP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3320 ELMWOOD BEACH RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49333-8771
Mailing Address - Country:US
Mailing Address - Phone:269-270-4271
Mailing Address - Fax:
Practice Address - Street 1:900 PEELER ST STE B
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-2380
Practice Address - Country:US
Practice Address - Phone:269-345-8618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704351967367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered