Provider Demographics
NPI:1831831593
Name:MORGAN, ALEXANDRA EVELYN (FNP-C)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:EVELYN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10821 N HIDEOUT CV
Mailing Address - Street 2:
Mailing Address - City:HIDEOUT
Mailing Address - State:UT
Mailing Address - Zip Code:84036-9379
Mailing Address - Country:US
Mailing Address - Phone:985-705-5546
Mailing Address - Fax:
Practice Address - Street 1:1393 E SEGO LILY DR
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84092-4350
Practice Address - Country:US
Practice Address - Phone:801-619-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11860023-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily