Basic Information
Provider Information
NPI: 1548669526
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NARANJO
FirstName: MORGAN
MiddleName: BRYAN
NamePrefix: MRS.
NameSuffix:  
Credential: FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BRYAN
OtherFirstName: MORGAN
OtherMiddleName: DANIELLE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: FNP-C
OtherLastNameType: 1
Mailing Information
Address1: 310 GASLIGHT BLVD
Address2:  
City: LUFKIN
State: TX
PostalCode: 759043133
CountryCode: US
TelephoneNumber: 9366328787
FaxNumber:  
Practice Location
Address1: 310 GASLIGHT BLVD
Address2:  
City: LUFKIN
State: TX
PostalCode: 759043133
CountryCode: US
TelephoneNumber: 9366328787
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/15/2014
LastUpdateDate: 12/20/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP126247TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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