Provider Demographics
NPI:1043853955
Name:CHURCH, RUTH MORRIS (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:MORRIS
Last Name:CHURCH
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MRS
Other - First Name:RUTH
Other - Middle Name:MORRIS
Other - Last Name:CHURCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RUTH MORRIS, BSN, RN
Mailing Address - Street 1:27731 EASTLAND DR
Mailing Address - Street 2:
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-7549
Mailing Address - Country:US
Mailing Address - Phone:256-777-6746
Mailing Address - Fax:
Practice Address - Street 1:8216 MADISON BLVD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2002
Practice Address - Country:US
Practice Address - Phone:256-464-9991
Practice Address - Fax:256-464-9994
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-054980363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health