Healthcare Provider Details

I. General information

NPI: 1699273839
Provider Name (Legal Business Name): JUSTIN NEAL MORGAN APRN-CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3352 N FUTRALL DR
FAYETTEVILLE AR
72703-4057
US

IV. Provider business mailing address

3317 N WIMBERLY DR
FAYETTEVILLE AR
72703-4056
US

V. Phone/Fax

Practice location:
  • Phone: 479-587-3149
  • Fax: 479-521-4603
Mailing address:
  • Phone: 479-587-3149
  • Fax: 479-521-4603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberATP-001246
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA005503
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: