Provider Demographics
NPI:1194394148
Name:MORGAN, JENNIFER TULL (MS, OTR/L, MBA, CLT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:TULL
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MS, OTR/L, MBA, CLT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:TULL
Other - Last Name:KINSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L, MBA, CLT
Mailing Address - Street 1:PO BOX 863
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37354-0863
Mailing Address - Country:US
Mailing Address - Phone:423-545-9544
Mailing Address - Fax:423-545-9554
Practice Address - Street 1:415 ISBILL RD STE E
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37354-2148
Practice Address - Country:US
Practice Address - Phone:423-545-9544
Practice Address - Fax:423-545-9554
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-23
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XE1200X, 225XG0600X, 225XH1200X, 225XN1300X, 225XP0019X
TN3293225XP0019X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomicsGroup - Multi-Specialty
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation