=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710709787
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MORGAN MARSH RD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/30/2024
-----------------------------------------------------
Last Update Date | 07/31/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 W HOSPITAL DR.
-----------------------------------------------------
City | WHITERIVER
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85941
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 928-338-3639
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 W HOSPITAL DR.
-----------------------------------------------------
City | WHITERIVER
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85491
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 269-808-2150
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number | 86326415
-----------------------------------------------------
License Number State |
-----------------------------------------------------