Provider Demographics
NPI:1447667894
Name:MORGAN, ALISHIA (LPN)
Entity type:Individual
Prefix:
First Name:ALISHIA
Middle Name:
Last Name:MORGAN
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 1:2045 REFLECTIVE WATERS RD
Mailing Address - Street 2:
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-6971
Mailing Address - Country:US
Mailing Address - Phone:727-481-4122
Mailing Address - Fax:
Practice Address - Street 1:2045 REFLECTIVE WATERS RD
Practice Address - Street 2:
Practice Address - City:VILLA RICA
Practice Address - State:GA
Practice Address - Zip Code:30180-6971
Practice Address - Country:US
Practice Address - Phone:727-481-4122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN089026164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse