Provider Demographics
NPI:1619622552
Name:MORGAN, ALLISON SANDERS
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:SANDERS
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-2901
Mailing Address - Country:US
Mailing Address - Phone:843-549-1558
Mailing Address - Fax:843-549-1454
Practice Address - Street 1:107 CHURCH ST
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-2901
Practice Address - Country:US
Practice Address - Phone:843-549-1558
Practice Address - Fax:843-549-1454
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
SC26411363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program