Healthcare Provider Details

I. General information

NPI: 1750910246
Provider Name (Legal Business Name): MORGAN HOLNAIDER CSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

284 HARRIS LOOP
DALLAS GA
30157-8201
US

IV. Provider business mailing address

5058 KINGSBRIDGE PASS
POWDER SPRINGS GA
30127-6936
US

V. Phone/Fax

Practice location:
  • Phone: 770-733-7140
  • Fax:
Mailing address:
  • Phone: 770-733-7140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: