Provider Demographics
NPI:1144545377
Name:MORGAN, MEEDEESSA O (FNP)
Entity type:Individual
Prefix:MRS
First Name:MEEDEESSA
Middle Name:O
Last Name:MORGAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:MEEDEESSA
Other - Middle Name:O
Other - Last Name:LIVINGSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:480 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:JBPHH
Mailing Address - State:HI
Mailing Address - Zip Code:96860-4908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL YOKOSUKA JAPAN
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96530
Practice Address - Country:US
Practice Address - Phone:810-465-1666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX718455363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily