Provider Demographics
NPI:1497872329
Name:MORGAN, BONNIE LOU (CNA)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:LOU
Last Name:MORGAN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 TIELMAN RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17921-9295
Mailing Address - Country:US
Mailing Address - Phone:570-875-2245
Mailing Address - Fax:570-875-2523
Practice Address - Street 1:121 TIELMAN RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:PA
Practice Address - Zip Code:17921-9295
Practice Address - Country:US
Practice Address - Phone:570-875-2245
Practice Address - Fax:570-875-2523
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA9949034376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide