Provider Demographics
NPI:1225840556
Name:YATES, MORGIN RENEE (STNA)
Entity type:Individual
Prefix:MS
First Name:MORGIN
Middle Name:RENEE
Last Name:YATES
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:MORGIN
Other - Middle Name:R
Other - Last Name:YATES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:STNA
Mailing Address - Street 1:1600 LANCEWOOD PL
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-1021
Mailing Address - Country:US
Mailing Address - Phone:567-307-1017
Mailing Address - Fax:
Practice Address - Street 1:1600 LANCEWOOD PL
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-1021
Practice Address - Country:US
Practice Address - Phone:567-307-1017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH322210720911376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide