Provider Demographics
NPI:1962260851
Name:LONGTIN, MORGAN MARIE (FNP-C)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:MARIE
Last Name:LONGTIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31505 COUNTY ROAD 8
Mailing Address - Street 2:
Mailing Address - City:STRATHCONA
Mailing Address - State:MN
Mailing Address - Zip Code:56759-9552
Mailing Address - Country:US
Mailing Address - Phone:701-520-9429
Mailing Address - Fax:
Practice Address - Street 1:600 MAIN AVE S
Practice Address - Street 2:
Practice Address - City:BAUDETTE
Practice Address - State:MN
Practice Address - Zip Code:56623-2855
Practice Address - Country:US
Practice Address - Phone:218-634-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND200552363LP2300X
MN11370363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care