Provider Demographics
NPI:1922361740
Name:MORRISON, LYNNETTE ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNNETTE
Middle Name:ANNE
Last Name:MORRISON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10068 WAGER RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-9049
Mailing Address - Country:US
Mailing Address - Phone:801-673-1393
Mailing Address - Fax:479-763-3066
Practice Address - Street 1:1160 S 40TH ST
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-4832
Practice Address - Country:US
Practice Address - Phone:479-756-1702
Practice Address - Fax:479-756-1742
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV26063207Q00000X
ARE-9342207QH0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR216681001Medicaid