Provider Demographics
NPI:1699179481
Name:MORGAN, MICHELE L (LPN)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:L
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:MAROLF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2400 S 48TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-6683
Mailing Address - Country:US
Mailing Address - Phone:479-750-2020
Mailing Address - Fax:479-750-4843
Practice Address - Street 1:1200 W WALNUT ST
Practice Address - Street 2:SUITE 1400
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3521
Practice Address - Country:US
Practice Address - Phone:479-725-6000
Practice Address - Fax:479-750-4843
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARL017014164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse