Provider Demographics
NPI:1922796549
Name:MORGAN, JALISSA DENISE
Entity Type:Individual
Prefix:
First Name:JALISSA
Middle Name:DENISE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 LEASE ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-1021
Mailing Address - Country:US
Mailing Address - Phone:216-703-7805
Mailing Address - Fax:
Practice Address - Street 1:340 LEASE ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-1021
Practice Address - Country:US
Practice Address - Phone:216-703-7805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide