Healthcare Provider Details

I. General information

NPI: 1013804772
Provider Name (Legal Business Name): TONYA MORGAN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6784 HIGHWAY 411
BENTON TN
37307-4818
US

IV. Provider business mailing address

6784 HIGHWAY 411
BENTON TN
37307-4818
US

V. Phone/Fax

Practice location:
  • Phone: 423-255-7933
  • Fax: 423-338-8996
Mailing address:
  • Phone: 423-255-7933
  • Fax: 423-338-8996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number39015
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: