Basic Information
Provider Information
NPI: 1265085849
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORROW
FirstName: CINDY
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CANNON
OtherFirstName: CINDY
OtherMiddleName: MARIE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 3300 S BODENBURG LOOP
Address2:  
City: PALMER
State: AK
PostalCode: 996458592
CountryCode: US
TelephoneNumber: 9078419459
FaxNumber:  
Practice Location
Address1: 670 W FIREWEED LN STE 160
Address2:  
City: ANCHORAGE
State: AK
PostalCode: 995032561
CountryCode: US
TelephoneNumber: 9077700862
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/22/2019
LastUpdateDate: 07/22/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000XNURP6147AKY Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


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