MEDICARE: MR. BILLY FRANKLIN MORALES

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	363L00000X	Nurse Practitioner	F0710432	LA
2	363L00000X	Nurse Practitioner	RN113393-APO6243	LA
3	363LF0000X	Family Nurse Practitioner	1-169017	AL

General Provider Information

NPI Number	:	1629386347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BILLY FRANKLIN MORALES

Provider Business Mailing Address
First Line	:	101 E 15TH AVE
Second Line	:
City	:	GULF SHORES
State	:	AL
Zip	:	36542-3501
Country	:	US
Telephone Number	:	251-962-1250
Fax Number	:	251-967-7832

Provider Business Practice Location Address
First Line	:	101 E 15TH AVE
Second Line	:
City	:	GULF SHORES
State	:	AL
Zip	:	36542-3501
Country	:	US
Telephone Number	:	251-962-1250
Fax Number	:	251-967-7832

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

Provider Enumeration Date	:	09/15/2010
Last Update Date	:	09/06/2023

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