Provider Demographics
NPI:1790257988
Name:PHILLIPS, MORGAN (RN)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:PHILLIPS
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 1:790 EMORY VALLEY RD APT 118
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6523
Mailing Address - Country:US
Mailing Address - Phone:865-266-3651
Mailing Address - Fax:865-685-0527
Practice Address - Street 1:790 EMORY VALLEY RD APT 118
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6523
Practice Address - Country:US
Practice Address - Phone:865-266-3651
Practice Address - Fax:865-685-0527
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN224282163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse