Healthcare Provider Details

I. General information

NPI: 1518707223
Provider Name (Legal Business Name): MORGAN SEVERSEIKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 S UNIVERSITY AVE
LITTLE ROCK AR
72204-1000
US

IV. Provider business mailing address

518 E 7TH ST APT 16
LITTLE ROCK AR
72202-2593
US

V. Phone/Fax

Practice location:
  • Phone: 501-916-3127
  • Fax:
Mailing address:
  • Phone: 515-537-5677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: