Healthcare Provider Details

I. General information

NPI: 1497739429
Provider Name (Legal Business Name): ANGA-LEE MORGAN TIPTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGA-LEE MORGAN FNP-BC

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 05/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 VILLAGE VIEW DRIVE
GAINESVILLE GA
30506
US

IV. Provider business mailing address

4000 VILLAGE VIEW DRIVE
GAINESVILLE GA
30506
US

V. Phone/Fax

Practice location:
  • Phone: 678-450-3000
  • Fax: 678-450-1527
Mailing address:
  • Phone: 678-450-3000
  • Fax: 678-450-1527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number102211
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: