Provider Demographics
NPI:1952912958
Name:MORGAN, TINA (MS, APRN, FNP)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MS, APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 27TH ST STE 306
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-2669
Mailing Address - Country:US
Mailing Address - Phone:740-353-8661
Mailing Address - Fax:
Practice Address - Street 1:1711 27TH ST STE 306
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-2669
Practice Address - Country:US
Practice Address - Phone:174-046-4881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCNP.0026982363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily