Provider Demographics
NPI:1447963715
Name:MORGAN, ANNSHILETTE LEQUANZA
Entity type:Individual
Prefix:
First Name:ANNSHILETTE
Middle Name:LEQUANZA
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 HARBOUR TOWN CV
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30215-8042
Mailing Address - Country:US
Mailing Address - Phone:404-820-0723
Mailing Address - Fax:
Practice Address - Street 1:71 HARBOUR TOWN CV
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30215-8042
Practice Address - Country:US
Practice Address - Phone:404-820-0723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)