Provider Demographics
NPI:1336765197
Name:SMALLS, MORGAN SHARMEIKA (RN)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:SHARMEIKA
Last Name:SMALLS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SHARMEIKA
Other - Middle Name:
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 7412
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-0107
Mailing Address - Country:US
Mailing Address - Phone:585-721-1122
Mailing Address - Fax:
Practice Address - Street 1:601 ELMWOOD AVE.
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642
Practice Address - Country:US
Practice Address - Phone:585-275-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-17
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY775117311ZA0620X
FL9554617163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home