Provider Demographics
NPI:1538802558
Name:MORGAN, TAELOR T
Entity type:Individual
Prefix:
First Name:TAELOR
Middle Name:T
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 FORESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:45377-1905
Mailing Address - Country:US
Mailing Address - Phone:937-312-7590
Mailing Address - Fax:
Practice Address - Street 1:111 FORESTWOOD AVE
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:OH
Practice Address - Zip Code:45377-1905
Practice Address - Country:US
Practice Address - Phone:937-312-7590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No172A00000XOther Service ProvidersDriver
No372600000XNursing Service Related ProvidersAdult Companion