Healthcare Provider Details

I. General information

NPI: 1285392084
Provider Name (Legal Business Name): CAROLINE MARIE MORRISON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2021
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6823 ISAACS ORCHARD RD
SPRINGDALE AR
72762-6096
US

IV. Provider business mailing address

2709 SW HAMPTON AVE
BENTONVILLE AR
72713-3002
US

V. Phone/Fax

Practice location:
  • Phone: 479-750-2080
  • Fax:
Mailing address:
  • Phone: 181-770-7064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number218013
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: