Provider Demographics
NPI:1942590625
Name:MORGAN, MELISSA REEVES (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:REEVES
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10810 PARKSIDE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1983
Mailing Address - Country:US
Mailing Address - Phone:865-392-9220
Mailing Address - Fax:865-392-9221
Practice Address - Street 1:10810 PARKSIDE DR STE 201
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1983
Practice Address - Country:US
Practice Address - Phone:865-392-9220
Practice Address - Fax:865-392-9221
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNML0000021542246QM0706X
TN1951363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist