Healthcare Provider Details

I. General information

NPI: 1942590625
Provider Name (Legal Business Name): MELISSA REEVES MORGAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2011
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10810 PARKSIDE DR STE 201
KNOXVILLE TN
37934-1983
US

IV. Provider business mailing address

10810 PARKSIDE DR STE 201
KNOXVILLE TN
37934-1983
US

V. Phone/Fax

Practice location:
  • Phone: 865-392-9220
  • Fax: 865-392-9221
Mailing address:
  • Phone: 865-392-9220
  • Fax: 865-392-9221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License NumberML0000021542
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1951
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: