Provider Demographics
NPI:1053956433
Name:MORRISON, MONICA FAY (LPN)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:FAY
Last Name:MORRISON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 S STATE ROUTE 134 LOT 305
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177-9711
Mailing Address - Country:US
Mailing Address - Phone:937-725-0926
Mailing Address - Fax:
Practice Address - Street 1:2907 S STATE ROUTE 134 LOT 305
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-9711
Practice Address - Country:US
Practice Address - Phone:937-725-0926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-09
Last Update Date:2019-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN079176164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse