Healthcare Provider Details

I. General information

NPI: 1770407207
Provider Name (Legal Business Name): HANNAH SHARAE MORGAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MAPLE DR
VIDALIA GA
30474-8998
US

IV. Provider business mailing address

2494 KNOX MILL RD
SOPERTON GA
30457-5147
US

V. Phone/Fax

Practice location:
  • Phone: 912-535-3500
  • Fax:
Mailing address:
  • Phone: 912-293-5427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP205252
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: