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General NPI Number Information
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NPI Number | 1043853955
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Entity Type | Individual
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Provider Name | RUTH MORRIS CHURCH NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 10/23/2019
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 8216 MADISON BLVD
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City | MADISON
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State | AL
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Zip | 35758-2002
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Country | US
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Telephone | 256-464-9991
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Fax | 256-464-9994
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Provider Business Mailing Address
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Address Line | 27731 EASTLAND DR
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City | HARVEST
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State | AL
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Zip | 35749-7549
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Country | US
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Telephone | 256-777-6746
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1-054980
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License Number State | AL
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