Healthcare Provider Details

I. General information

NPI: 1710808001
Provider Name (Legal Business Name): NICOLE MORGAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 HAMPTON FOREST DR
COLUMBIA SC
29209-2576
US

IV. Provider business mailing address

104 HAMPTON FOREST DR
COLUMBIA SC
29209-2576
US

V. Phone/Fax

Practice location:
  • Phone: 803-271-8617
  • Fax:
Mailing address:
  • Phone: 803-271-8617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN229026
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: