Provider Demographics
NPI:1689258121
Name:GREEN, MORGAN (LVN)
Entity Type:Individual
Prefix:MS
First Name:MORGAN
Middle Name:
Last Name:GREEN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16033 COUNTY ROAD 4101
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-7239
Mailing Address - Country:US
Mailing Address - Phone:903-920-8114
Mailing Address - Fax:
Practice Address - Street 1:16033 COUNTY ROAD 4101
Practice Address - Street 2:
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771-7239
Practice Address - Country:US
Practice Address - Phone:903-920-8114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX350413164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse