MEDICARE: CATHERINE MORTON HANEY NNP-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	163W00000X	Registered Nurse	RN298038	GA
2	363LN0000X	Neonatal Nurse Practitioner	1044167271	FL

General Provider Information

NPI Number	:	1831976141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE MORTON HANEY NNP-BC

Provider Business Mailing Address
First Line	:	10140 CENTURION PKWY N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-0532
Country	:	US
Telephone Number	:	904-697-4100
Fax Number	:	904-697-5102

Provider Business Practice Location Address
First Line	:	10140 CENTURION PKWY N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-0532
Country	:	US
Telephone Number	:	904-697-4100
Fax Number	:	904-697-5102

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

Provider Enumeration Date	:	09/11/2023
Last Update Date	:	12/10/2025

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