Provider Demographics
NPI:1699090225
Name:ANDERSON, MORGAN ELLEN (LPN)
Entity type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:ELLEN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:MORGAN
Other - Middle Name:ELLEN
Other - Last Name:DEVERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:2610 W GALBRAITH RD
Mailing Address - Street 2:APT B-8
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-4269
Mailing Address - Country:US
Mailing Address - Phone:513-521-6254
Mailing Address - Fax:
Practice Address - Street 1:2610 W GALBRAITH RD
Practice Address - Street 2:APT B-8
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-4269
Practice Address - Country:US
Practice Address - Phone:513-521-6254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN137525164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse