Provider Demographics
NPI:1588093454
Name:MORGAN, LAVONNE (LPN)
Entity type:Individual
Prefix:
First Name:LAVONNE
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:LAVONNE
Other - Middle Name:L
Other - Last Name:GATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:846 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-3654
Mailing Address - Country:US
Mailing Address - Phone:216-224-9548
Mailing Address - Fax:
Practice Address - Street 1:846 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-3654
Practice Address - Country:US
Practice Address - Phone:216-224-9548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.152689-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse