Provider Demographics
NPI:1275554891
Name:MORRIS, LONNIE C (CNM ND)
Entity Type:Individual
Prefix:
First Name:LONNIE
Middle Name:C
Last Name:MORRIS
Suffix:
Gender:F
Credentials:CNM ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-1645
Mailing Address - Country:US
Mailing Address - Phone:201-567-0810
Mailing Address - Fax:201-567-5771
Practice Address - Street 1:716 BROAD ST
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-1645
Practice Address - Country:US
Practice Address - Phone:201-567-0810
Practice Address - Fax:201-567-5771
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00039400176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6421903Medicaid
NJ006224Medicare ID - Type Unspecified
NJ6421903Medicaid