Healthcare Provider Details

I. General information

NPI: 1770374084
Provider Name (Legal Business Name): MORGAN RACHELLE PORTER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MORGAN RACHELLE FLORES

II. Dates (important events)

Enumeration Date: 05/15/2025
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 E MAIN ST
JUNCTION CITY OH
43748-9701
US

IV. Provider business mailing address

39680 DAWLEY NEW PITTSBURG RD
LOGAN OH
43138-9161
US

V. Phone/Fax

Practice location:
  • Phone: 740-715-3160
  • Fax:
Mailing address:
  • Phone: 719-565-9896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0039133
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: