Healthcare Provider Details

I. General information

NPI: 1922890441
Provider Name (Legal Business Name): JENNA ANZALONE MORGAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNA ANZALONE MORGAN

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15813 PAUL VEGA MD DR STE 201
HAMMOND LA
70403-1431
US

IV. Provider business mailing address

PO BOX 1469
INDEPENDENCE LA
70443-1469
US

V. Phone/Fax

Practice location:
  • Phone: 985-230-7440
  • Fax:
Mailing address:
  • Phone: 985-687-7351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number210405
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number210405
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: