Provider Demographics
NPI:1730879065
Name:MOHLER, MORGAN GRACE
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:GRACE
Last Name:MOHLER
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 1:17100 BURKHOLDER RD
Mailing Address - Street 2:
Mailing Address - City:FRAZEYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43822-9547
Mailing Address - Country:US
Mailing Address - Phone:740-258-0298
Mailing Address - Fax:
Practice Address - Street 1:17100 BURKHOLDER RD
Practice Address - Street 2:
Practice Address - City:FRAZEYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43822-9547
Practice Address - Country:US
Practice Address - Phone:740-258-0298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker