Provider Demographics
NPI:1922482561
Name:MORGAN, MICHELE D (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:D
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 COURT ST
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24504-1312
Mailing Address - Country:US
Mailing Address - Phone:434-485-8862
Mailing Address - Fax:434-485-8877
Practice Address - Street 1:2235 LANDOVER PL
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2193
Practice Address - Country:US
Practice Address - Phone:434-847-8000
Practice Address - Fax:434-847-6094
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001235956163WP0808X
VA0024180427363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health