Provider Demographics
NPI:1629627872
Name:MORROW, RICHARD (RN-BSN, AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:MORROW
Suffix:
Gender:M
Credentials:RN-BSN, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-4557
Mailing Address - Country:US
Mailing Address - Phone:860-942-9461
Mailing Address - Fax:
Practice Address - Street 1:102 POMONA DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1616
Practice Address - Country:US
Practice Address - Phone:336-299-0000
Practice Address - Fax:336-299-2335
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2320616163W00000X
NC5012614363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse