Healthcare Provider Details

I. General information

NPI: 1821623950
Provider Name (Legal Business Name): ELLEN JOY MORRIS MS RD LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2020
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S HORSEBARN RD
ROGERS AR
72758-8184
US

IV. Provider business mailing address

1001 S HORSEBARN RD
ROGERS AR
72758-8184
US

V. Phone/Fax

Practice location:
  • Phone: 479-273-7700
  • Fax: 479-464-7734
Mailing address:
  • Phone: 479-273-7700
  • Fax: 479-464-7734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number1747
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: