Healthcare Provider Details

I. General information

NPI: 1245752070
Provider Name (Legal Business Name): MORGAN BRITTANY SHIRLEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2017
Last Update Date: 07/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 E. MAIN ST.
MELBOURNE AR
72556
US

IV. Provider business mailing address

226 NELLY BELLE LN
BATESVILLE AR
72501-9005
US

V. Phone/Fax

Practice location:
  • Phone: 870-368-4729
  • Fax:
Mailing address:
  • Phone: 870-291-4658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA005204
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: