Provider Demographics
NPI:1013569060
Name:HEMMINGSEN, MORGAN NICOLE
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:NICOLE
Last Name:HEMMINGSEN
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 1:4800 OLD HIGHWAY 48
Mailing Address - Street 2:
Mailing Address - City:CUNNINGHAM
Mailing Address - State:TN
Mailing Address - Zip Code:37052-4958
Mailing Address - Country:US
Mailing Address - Phone:931-561-9285
Mailing Address - Fax:
Practice Address - Street 1:800 WEATHERLY DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-8957
Practice Address - Country:US
Practice Address - Phone:931-647-6561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN42115183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist