Provider Demographics
NPI:1184857690
Name:MORGAN-DILDINE, COURTNEY MARIE (APN)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MARIE
Last Name:MORGAN-DILDINE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 HOLIDAY DR
Mailing Address - Street 2:SUITE 406
Mailing Address - City:FORREST CITY
Mailing Address - State:AR
Mailing Address - Zip Code:72335-9183
Mailing Address - Country:US
Mailing Address - Phone:870-494-4000
Mailing Address - Fax:870-494-4033
Practice Address - Street 1:904 HOLIDAY DR
Practice Address - Street 2:SUITE 406
Practice Address - City:FORREST CITY
Practice Address - State:AR
Practice Address - Zip Code:72335-9183
Practice Address - Country:US
Practice Address - Phone:870-494-4000
Practice Address - Fax:870-494-4033
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03294363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily