Provider Demographics
NPI:1689113482
Name:MORGAN, JASON EVAN (APRN)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:EVAN
Last Name:MORGAN
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6258 SNOWMASS DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-7229
Mailing Address - Country:US
Mailing Address - Phone:513-304-1175
Mailing Address - Fax:513-844-6358
Practice Address - Street 1:10 N LOCUST ST STE D
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-1182
Practice Address - Country:US
Practice Address - Phone:513-523-2340
Practice Address - Fax:513-523-5080
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN295536163W00000X
OHAPRN.CNP.020516363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0223676Medicaid