MEDICARE: MRS. DANA MARIE MORGAN FNP-BC, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN197511	GA

General Provider Information

NPI Number	:	1043761331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANA MARIE MORGAN FNP-BC, PMHNP-BC

Provider Business Mailing Address
First Line	:	1610 ALICE ST
Second Line	:
City	:	WAYCROSS
State	:	GA
Zip	:	31501-4533
Country	:	US
Telephone Number	:	912-550-8892
Fax Number	:

Provider Business Practice Location Address
First Line	:	1610 ALICE ST
Second Line	:
City	:	WAYCROSS
State	:	GA
Zip	:	31501-4533
Country	:	US
Telephone Number	:	912-584-3263
Fax Number	:	912-809-2296

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2016
Last Update Date	:	04/22/2025

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