Provider Demographics
NPI:1922744259
Name:MORGAN, TIMOTHY HARRISON
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:HARRISON
Last Name:MORGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 W MAIN ST STE 32
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-7325
Mailing Address - Country:US
Mailing Address - Phone:615-431-2362
Mailing Address - Fax:
Practice Address - Street 1:315 W MAIN ST STE 32
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-7325
Practice Address - Country:US
Practice Address - Phone:615-431-2362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1000000030718253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care