Provider Demographics
NPI:1063017119
Name:CROUCHER, MORGAN GENE (LPN)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:GENE
Last Name:CROUCHER
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8847 SALEM RD
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45338-6703
Mailing Address - Country:US
Mailing Address - Phone:937-733-8926
Mailing Address - Fax:
Practice Address - Street 1:8847 SALEM RD
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:OH
Practice Address - Zip Code:45338-6703
Practice Address - Country:US
Practice Address - Phone:937-733-8926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH174152.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse