Provider Demographics
NPI:1417946104
Name:MORRILL-CORNELIUS, SHANNON MARIE (MS, LGC)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:MARIE
Last Name:MORRILL-CORNELIUS
Suffix:
Gender:F
Credentials:MS, LGC
Other - Prefix:MRS
Other - First Name:SHANNON
Other - Middle Name:MARIE
Other - Last Name:MORRILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LGC
Mailing Address - Street 1:ONE MEDICAL CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-0001
Mailing Address - Country:US
Mailing Address - Phone:603-653-3541
Mailing Address - Fax:603-653-3583
Practice Address - Street 1:ONE MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-0001
Practice Address - Country:US
Practice Address - Phone:603-653-3541
Practice Address - Fax:603-653-3583
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS