Provider Demographics
NPI:1174122790
Name:MORNINGSTAR, SCOTT ERIC (APRN)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ERIC
Last Name:MORNINGSTAR
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5563 SW 84TH LN
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-8511
Mailing Address - Country:US
Mailing Address - Phone:352-857-9969
Mailing Address - Fax:
Practice Address - Street 1:5563 SW 84TH LN
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-8511
Practice Address - Country:US
Practice Address - Phone:352-857-9969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-23
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009882363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner