Healthcare Provider Details

I. General information

NPI: 1457292542
Provider Name (Legal Business Name): JOHNETTA MORGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4758 WOODMERE BLVD STE F
MONTGOMERY AL
36106-3076
US

IV. Provider business mailing address

4758 WOODMERE BLVD STE F
MONTGOMERY AL
36106-3076
US

V. Phone/Fax

Practice location:
  • Phone: 888-464-1908
  • Fax:
Mailing address:
  • Phone: 888-464-1908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number32253
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: