Basic Information
Provider Information
NPI: 1215194055
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORGAN
FirstName: DARIN
MiddleName: PAUL
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1014 AUTUMN RD STE 3
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722113768
CountryCode: US
TelephoneNumber: 5012211941
FaxNumber: 5012211553
Practice Location
Address1: 1014 AUTUMN RD STE 3
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722113768
CountryCode: US
TelephoneNumber: 5012211941
FaxNumber: 5012211553
Other Information
ProviderEnumerationDate: 05/20/2008
LastUpdateDate: 05/20/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WP0808XR66828ARY Nursing Service ProvidersRegistered NursePsych/Mental Health

No ID Information.


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