Healthcare Provider Details

I. General information

NPI: 1083764377
Provider Name (Legal Business Name): MRS. ANGELA B. MORRISON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5935 CAMERON ST
SCOTT LA
70583-5182
US

IV. Provider business mailing address

PO BOX 52900
LAFAYETTE LA
70505-2900
US

V. Phone/Fax

Practice location:
  • Phone: 337-264-0326
  • Fax: 337-264-0328
Mailing address:
  • Phone: 337-264-0326
  • Fax: 337-264-0328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number04562
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: