Healthcare Provider Details

I. General information

NPI: 1114836731
Provider Name (Legal Business Name): MORGAN MCDOWELL KENNEL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 HIGHWAY 466
LADY LAKE FL
32159-3918
US

IV. Provider business mailing address

3168 SE HIGHWAY 42
SUMMERFIELD FL
34491-5011
US

V. Phone/Fax

Practice location:
  • Phone: 352-205-1268
  • Fax:
Mailing address:
  • Phone: 352-205-1268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11050647
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: