Provider Demographics
NPI:1497534580
Name:MORGAN, ANGELA L (STNA)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:L
Last Name:MORGAN
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:L
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:745 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1265
Mailing Address - Country:US
Mailing Address - Phone:937-561-8479
Mailing Address - Fax:
Practice Address - Street 1:745 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1265
Practice Address - Country:US
Practice Address - Phone:937-561-8479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400606930407376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide