Provider Demographics
NPI:1679163323
Name:LETSON, GINGER MORGAN (CRNP)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:MORGAN
Last Name:LETSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 HAWTHORN WAY
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:AL
Mailing Address - Zip Code:35673-6018
Mailing Address - Country:US
Mailing Address - Phone:256-345-5583
Mailing Address - Fax:
Practice Address - Street 1:2941 POINT MALLARD PKWY SE STE N
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-5760
Practice Address - Country:US
Practice Address - Phone:256-432-2822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALF01210070363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily