Provider Demographics
NPI:1215925284
Name:MORRIS LUNDGREN, MARJORIE J (CNM)
Entity type:Individual
Prefix:MRS
First Name:MARJORIE
Middle Name:J
Last Name:MORRIS LUNDGREN
Suffix:
Gender:F
Credentials:CNM
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Mailing Address - Street 1:6071 E WOODMEN RD
Mailing Address - Street 2:STE 405
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-2614
Mailing Address - Country:US
Mailing Address - Phone:303-873-5245
Mailing Address - Fax:303-873-5240
Practice Address - Street 1:6071 E WOODMEN RD STE 405
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-2614
Practice Address - Country:US
Practice Address - Phone:719-442-0808
Practice Address - Fax:719-622-3400
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO1827367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07781487Medicaid
COCO306941Medicare PIN
CO07781487Medicaid
COC810258Medicare PIN