Healthcare Provider Details

I. General information

NPI: 1407623762
Provider Name (Legal Business Name): MORGAN C PITTS BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2023
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 FOUNTAINS BLVD
MADISON MS
39110-6343
US

IV. Provider business mailing address

120 FOUNTAINS BLVD
MADISON MS
39110-6343
US

V. Phone/Fax

Practice location:
  • Phone: 601-488-0662
  • Fax:
Mailing address:
  • Phone: 601-488-0662
  • Fax: 769-206-4650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number907785
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number891649
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: