Provider Demographics
NPI:1396254488
Name:MORGAN, AMY DIANE (ARNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:DIANE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:DIANE
Other - Last Name:FRANK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:3301 SW 34TH CIR STE 302
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-6615
Mailing Address - Country:US
Mailing Address - Phone:352-304-6566
Mailing Address - Fax:352-421-9328
Practice Address - Street 1:3301 SW 34TH CIR STE 302
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-6615
Practice Address - Country:US
Practice Address - Phone:352-304-6566
Practice Address - Fax:352-421-9328
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9217325363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN9217325OtherMEDICAL LICENSE
FL022667500Medicaid