MEDICARE: PEGGY SUSAN MORROW APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	CNS501007	AR

General Provider Information

NPI Number	:	1174617385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEGGY SUSAN MORROW APN

Provider Business Mailing Address
First Line	:	3805 MCCAIN PARK DR 116
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-7813
Country	:	US
Telephone Number	:	501-758-9993
Fax Number	:	501-771-4885

Provider Business Practice Location Address
First Line	:	3805 MCCAIN PARK DR 116
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-7813
Country	:	US
Telephone Number	:	501-771-4693
Fax Number	:	501-771-4885

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	09/02/2015

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