Provider Demographics
NPI:1619723301
Name:ZIMMERLY, MORGAN LYNN
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:LYNN
Last Name:ZIMMERLY
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 1:303 S ASHBERRY LN
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:OH
Mailing Address - Zip Code:45875-3007
Mailing Address - Country:US
Mailing Address - Phone:567-376-0014
Mailing Address - Fax:
Practice Address - Street 1:11764 ROAD J
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:OH
Practice Address - Zip Code:45875-9435
Practice Address - Country:US
Practice Address - Phone:419-236-8829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH602686010723376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide