Provider Demographics
NPI:1588284285
Name:CHAMBERS, MORGAN NICOLE
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:NICOLE
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 WALLACETON RD
Mailing Address - Street 2:
Mailing Address - City:MORRISDALE
Mailing Address - State:PA
Mailing Address - Zip Code:16858-8431
Mailing Address - Country:US
Mailing Address - Phone:814-574-1612
Mailing Address - Fax:
Practice Address - Street 1:675 WALLACETON RD
Practice Address - Street 2:
Practice Address - City:MORRISDALE
Practice Address - State:PA
Practice Address - Zip Code:16858-8431
Practice Address - Country:US
Practice Address - Phone:814-574-1612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-22
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X, 390200000X
NJ40QA02309800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program