Healthcare Provider Details

I. General information

NPI: 1669589123
Provider Name (Legal Business Name): HILLARY LISSORN MORGAN NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11710 E US HIGHWAY 92 SUITE B
SEFFNER FL
33584-3476
US

IV. Provider business mailing address

907 N PARSONS AVE
BRANDON FL
33510-3107
US

V. Phone/Fax

Practice location:
  • Phone: 813-689-8020
  • Fax: 813-689-8381
Mailing address:
  • Phone: 813-689-8020
  • Fax: 813-689-8381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP2750432
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: