Healthcare Provider Details

I. General information

NPI: 1265367015
Provider Name (Legal Business Name): MORGAN BOONE SMITH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10235 JEFFERSON HWY STE C
BATON ROUGE LA
70809-3195
US

IV. Provider business mailing address

251 RENEE DR
BATON ROUGE LA
70810-4060
US

V. Phone/Fax

Practice location:
  • Phone: 337-692-5958
  • Fax:
Mailing address:
  • Phone: 337-692-5958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number206051
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: