Basic Information
Provider Information
NPI: 1003320649
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORGAN-ROPPELT
FirstName: LACEY
MiddleName: ELIZABETH
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MORGAN
OtherFirstName: LACEY
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 6350 W ANDREW JOHNSON HWY DEPT 100
Address2:  
City: TALBOTT
State: TN
PostalCode: 378778605
CountryCode: US
TelephoneNumber: 8003553565
FaxNumber: 4237142355
Practice Location
Address1: 2018 WESTERN AVE
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379215718
CountryCode: US
TelephoneNumber: 8655440406
FaxNumber: 8655440480
Other Information
ProviderEnumerationDate: 11/17/2017
LastUpdateDate: 11/17/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
246RP1900X  Y Technologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy

No ID Information.


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