Provider Demographics
NPI:1710696083
Name:MORROW, MINDI LEE (LPN)
Entity Type:Individual
Prefix:
First Name:MINDI
Middle Name:LEE
Last Name:MORROW
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TELETECH DR
Mailing Address - Street 2:
Mailing Address - City:MOUNDSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26041-2790
Mailing Address - Country:US
Mailing Address - Phone:304-843-3379
Mailing Address - Fax:
Practice Address - Street 1:180 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:WV
Practice Address - Zip Code:26033-9781
Practice Address - Country:US
Practice Address - Phone:304-238-3929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22916164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty