Healthcare Provider Details

I. General information

NPI: 1093641144
Provider Name (Legal Business Name): MORGAN NICOLE WATSON CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS MORGAN YOUNGBLOOD

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3885 OBERLIN AVE
LORAIN OH
44053-2813
US

IV. Provider business mailing address

1531 TRARES RD
MOGADORE OH
44260-9347
US

V. Phone/Fax

Practice location:
  • Phone: 440-989-5200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberAPRN.CNS.0019543
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: