Provider Demographics
NPI:1821323239
Name:CORNWALL, MORGAN RUTH (CD (DONA, HCHI, HCHD)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:RUTH
Last Name:CORNWALL
Suffix:
Gender:F
Credentials:CD (DONA, HCHI, HCHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6924 W PETRIE ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-7420
Mailing Address - Country:US
Mailing Address - Phone:208-761-6855
Mailing Address - Fax:
Practice Address - Street 1:6924 W PETRIE ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-7420
Practice Address - Country:US
Practice Address - Phone:208-761-6855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-03
Last Update Date:2009-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula