1174890339 NPI number — MS. ANDREA TRENA MORGAN LICENSED PROFESSIONA

Table of content: MS. ANDREA TRENA MORGAN LICENSED PROFESSIONA (NPI 1174890339)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174890339 NPI number — MS. ANDREA TRENA MORGAN LICENSED PROFESSIONA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORGAN
Provider First Name:
ANDREA
Provider Middle Name:
TRENA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LICENSED PROFESSIONA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GARRETT
Provider Other First Name:
ANDREA
Provider Other Middle Name:
TRENA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1174890339
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40128 CYPRESS RESERVE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PONCHATOULA
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70454
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-237-2219
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ST. TAMMANY PARISH PUBLIC SCHOOLS
Provider Second Line Business Practice Location Address:
321 NORTH THEARD STREET
Provider Business Practice Location Address City Name:
COVINGTON
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-892-2276
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/16/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  4533 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)