Provider Demographics
NPI:1023653227
Name:JAMISON, MORGAN LENORA
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:LENORA
Last Name:JAMISON
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 1:424 MAPLE GROVE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-8944
Mailing Address - Country:US
Mailing Address - Phone:704-345-4748
Mailing Address - Fax:
Practice Address - Street 1:102 W WILSON ST
Practice Address - Street 2:
Practice Address - City:WINGATE
Practice Address - State:NC
Practice Address - Zip Code:28174-6747
Practice Address - Country:US
Practice Address - Phone:704-233-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP519862OtherEMERGENCY MEDICAL TECHNICIAN
E3490723OtherNATIONAL REGISTRY EMERGENCY MEDICAL TECHNICIAN