Provider Demographics
NPI:1144935024
Name:FARRAH, MORGAN SANDERS (FNP-C)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:SANDERS
Last Name:FARRAH
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 1:3021 HOLLY BERRY CT
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-5185
Mailing Address - Country:US
Mailing Address - Phone:336-870-1805
Mailing Address - Fax:
Practice Address - Street 1:1310 AZALEA CT STE J
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-5724
Practice Address - Country:US
Practice Address - Phone:843-213-1633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26730363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner