Provider Demographics
NPI:1871142927
Name:SOMERS, MORGAN NICOLE (PA-C)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:NICOLE
Last Name:SOMERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:NICOLE
Other - Last Name:DEWITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:408 NORTHWEST ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:OH
Mailing Address - Zip Code:44811-1204
Mailing Address - Country:US
Mailing Address - Phone:419-357-4858
Mailing Address - Fax:
Practice Address - Street 1:770 W HIGH ST STE 300
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-5914
Practice Address - Country:US
Practice Address - Phone:419-996-5033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant