Basic Information
Provider Information
NPI: 1417683079
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WARNER
FirstName: MORGAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 507 HURRICANE AVE
Address2:  
City: HURRICANE
State: WV
PostalCode: 255261625
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 6354 US ROUTE 60 E STE 4
Address2:  
City: BARBOURSVILLE
State: WV
PostalCode: 255041247
CountryCode: US
TelephoneNumber: 3047331626
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/26/2022
LastUpdateDate: 07/26/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/17/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WH0200X94432WVY Nursing Service ProvidersRegistered NurseHome Health

No ID Information.


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