Provider Demographics
NPI:1669774402
Name:MORGAN, JENNIFER (LM, CPM)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:O NEALS
Mailing Address - State:CA
Mailing Address - Zip Code:93645-0163
Mailing Address - Country:US
Mailing Address - Phone:559-240-4370
Mailing Address - Fax:
Practice Address - Street 1:25683 BLUEBIRD TRL
Practice Address - Street 2:
Practice Address - City:COARSEGOLD
Practice Address - State:CA
Practice Address - Zip Code:93614-9600
Practice Address - Country:US
Practice Address - Phone:559-240-4370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM288176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife