Provider Demographics
NPI:1396517488
Name:MORIGEAU, KAYLA (FNP)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:MORIGEAU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38609 N CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:BEACH PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60099-3461
Mailing Address - Country:US
Mailing Address - Phone:224-789-9388
Mailing Address - Fax:
Practice Address - Street 1:425 SMELTER AVE NE
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-1927
Practice Address - Country:US
Practice Address - Phone:406-247-7130
Practice Address - Fax:406-247-7228
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.028010363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily