Provider Demographics
NPI:1104374479
Name:MORGAN, CONSTANCE LYNN (RN)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:LYNN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 HORNS MILL RD
Mailing Address - Street 2:
Mailing Address - City:SUGAR GROVE
Mailing Address - State:OH
Mailing Address - Zip Code:43155-9765
Mailing Address - Country:US
Mailing Address - Phone:740-415-7216
Mailing Address - Fax:
Practice Address - Street 1:2930 HORNS MILL RD
Practice Address - Street 2:
Practice Address - City:SUGAR GROVE
Practice Address - State:OH
Practice Address - Zip Code:43155-9765
Practice Address - Country:US
Practice Address - Phone:740-415-7216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN270458163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse