MEDICARE: MRS. SHAWNNA BOYD-MORRISON N.P.

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	363LW0102X	Women's Health Nurse Practitioner	467523	CA

General Provider Information

NPI Number	:	1689717829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHAWNNA BOYD-MORRISON N.P.

Provider Business Mailing Address
First Line	:	10 RUE VERTE
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-5205
Country	:	US
Telephone Number	:	949-722-2510
Fax Number	:	949-722-2511

Provider Business Practice Location Address
First Line	:	2077 HARBOR BLVD
Second Line	:	SUITE C
City	:	COSTA MESA
State	:	CA
Zip	:	92627-2630
Country	:	US
Telephone Number	:	949-722-2510
Fax Number	:	949-722-2511

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

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	07/02/2013

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