Healthcare Provider Details
I. General information
NPI: 1255816062
Provider Name (Legal Business Name): MORGAN L SCOTT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/27/2018
Last Update Date: 08/16/2021
Certification Date: 07/24/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
940 OLD WARREN RD.
MONTICELLO AR
71655-5729
US
IV. Provider business mailing address
940 OLD WARREN RD
MONTICELLO AR
71655-5729
US
V. Phone/Fax
- Phone: 870-723-1655
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WD0400X |
| Taxonomy | Diabetes Educator Registered Nurse |
| License Number | R101339 |
| License Number State | AR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 216423 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: