Provider Demographics
NPI:1639471709
Name:MORGAN, KELLEY LYNNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KELLEY
Middle Name:LYNNE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 DENNIS RD
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-6504
Mailing Address - Country:US
Mailing Address - Phone:740-454-9219
Mailing Address - Fax:
Practice Address - Street 1:1425 DENNIS RD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-6504
Practice Address - Country:US
Practice Address - Phone:740-454-9219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN296646163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse