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General NPI Number Information
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NPI Number | 1063425031
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Entity Type | Individual
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Provider Name | NICOLE QUESNETTE MORGAN PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 3705 TAMPA RD STE 22 ATLANTIS CLINIC
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City | OLDSMAR
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State | FL
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Zip | 34677-6346
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Country | US
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Telephone | 813-891-6343
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Fax | 813-891-6342
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Provider Business Mailing Address
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Address Line | 3705 TAMPA RD STE 22 ATLANTIS CLINIC
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City | OLDSMAR
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State | FL
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Zip | 34677-6346
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Country | US
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Telephone | 813-891-6343
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Fax | 813-891-6342
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA 9104263
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9104263
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9104263
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License Number State | FL
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