Amanda Chae Morgan, FNP-BC

Individual provider Active NPI Family Nurse Practitioner · Lake Park, GA

NPI 1669969465 · NPPES record last updated Apr 17, 2018

Key facts

NPI
1669969465
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
209139 (GA)
Practice address
5201 Sequani Cir
Lake Park, GA 31636-3241
Phone
(229) 300-5867
NPI assigned
Apr 17, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
209139GAMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LF0000X 209139 GA Yes

Addresses

Primary practice location

5201 Sequani Cir
Lake Park, GA 31636-3241

Mailing address

3014 N Patterson St
Valdosta, GA 31602-1711
Phone (229) 242-0194

Other providers in Lake Park, GA

All providers in Lake Park, GA · Family Nurse Practitioner in Georgia

Sources for this page

Verify at the official NPI Registry.