Provider Demographics
NPI:1306293436
Name:O'NEAL, MORGAN (AGACNP)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:O'NEAL
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:611 GRAMMONT ST.
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-7516
Mailing Address - Country:US
Mailing Address - Phone:318-325-2649
Mailing Address - Fax:318-388-4177
Practice Address - Street 1:611 GRAMMONT ST.
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7516
Practice Address - Country:US
Practice Address - Phone:318-325-2649
Practice Address - Fax:318-388-4177
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN132816163W00000X
LAAP08925363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse