Healthcare Provider Details

I. General information

NPI: 1346514924
Provider Name (Legal Business Name): MICHELLE MORGAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/29/2012
Last Update Date: 02/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 UNIVERSITY ST
MARTIN TN
38237-1605
US

IV. Provider business mailing address

406 N SPRING ST
MCMINNVILLE TN
37110-2134
US

V. Phone/Fax

Practice location:
  • Phone: 731-588-5829
  • Fax: 731-588-5834
Mailing address:
  • Phone: 931-507-1212
  • Fax: 931-507-1217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number157119
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: