Healthcare Provider Details

I. General information

NPI: 1942725833
Provider Name (Legal Business Name): LATONYA S MCMORRIS AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2017
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15784 MEDICAL ARTS DR STE A
HAMMOND LA
70403-1474
US

IV. Provider business mailing address

400 PARNASSUS AVE STE A808
SAN FRANCISCO CA
94143-2202
US

V. Phone/Fax

Practice location:
  • Phone: 985-230-7525
  • Fax: 985-230-7335
Mailing address:
  • Phone: 415-353-7500
  • Fax: 415-514-8949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number204337
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number902143
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number95021792
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number204337
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: