Provider Demographics
NPI:1679873319
Name:MORGAN, CORIANN RENE (RPH)
Entity Type:Individual
Prefix:
First Name:CORIANN
Middle Name:RENE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1310
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-0158
Mailing Address - Country:US
Mailing Address - Phone:307-463-4944
Mailing Address - Fax:307-856-9403
Practice Address - Street 1:511 N 12TH ST E
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-3809
Practice Address - Country:US
Practice Address - Phone:307-463-4944
Practice Address - Fax:307-856-9403
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3018183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist