Provider Demographics
NPI:1982218186
Name:HOLMES, MORGAN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MORGAN
Middle Name:
Last Name:HOLMES
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 1:65 COMMUNITY RD STE C
Mailing Address - Street 2:
Mailing Address - City:TALLMADGE
Mailing Address - State:OH
Mailing Address - Zip Code:44278-2358
Mailing Address - Country:US
Mailing Address - Phone:330-633-6601
Mailing Address - Fax:
Practice Address - Street 1:65 COMMUNITY RD STE C
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-2358
Practice Address - Country:US
Practice Address - Phone:330-633-6601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006611RX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical