Healthcare Provider Details

I. General information

NPI: 1063425031
Provider Name (Legal Business Name): NICOLE QUESNETTE MORGAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34637 US HIGHWAY 19 N
PALM HARBOR FL
34684-2152
US

IV. Provider business mailing address

2995 DREW ST FL 2
CLEARWATER FL
33759-3012
US

V. Phone/Fax

Practice location:
  • Phone: 727-216-0125
  • Fax: 727-333-6494
Mailing address:
  • Phone: 727-532-0002
  • Fax: 813-635-2613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9104263
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: