Provider Demographics
NPI:1407846488
Name:FORD MORGAN, NANCY (PT)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:FORD MORGAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1068 LACASA COURT
Mailing Address - Street 2:
Mailing Address - City:MONETA
Mailing Address - State:VA
Mailing Address - Zip Code:24121
Mailing Address - Country:US
Mailing Address - Phone:540-521-5514
Mailing Address - Fax:
Practice Address - Street 1:4064 POSTAL DR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-6438
Practice Address - Country:US
Practice Address - Phone:540-776-0200
Practice Address - Fax:540-777-5850
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305005744225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00385939OtherRAILROAD MEDICARE
VA7314740OtherAETNA
VA7314740OtherAETNA