Healthcare Provider Details

I. General information

NPI: 1114510831
Provider Name (Legal Business Name): TANYA SABRINA MOREY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2021
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 BAPTIST HEALTH DR
LITTLE ROCK AR
72205-6321
US

IV. Provider business mailing address

5800 W 10TH ST STE 610
LITTLE ROCK AR
72204-1772
US

V. Phone/Fax

Practice location:
  • Phone: 501-202-2000
  • Fax:
Mailing address:
  • Phone: 501-661-9393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number214704
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: