Provider Demographics
NPI:1174324255
Name:CHURCH, MORGAN VANESSA (STUDENT)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:VANESSA
Last Name:CHURCH
Suffix:
Gender:F
Credentials:STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1895 DICK PHILLIPS RD
Mailing Address - Street 2:
Mailing Address - City:WEST JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28694-7564
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:320 EMERGENCY ROOM DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-5035
Practice Address - Country:US
Practice Address - Phone:919-966-2281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program