1861540015 NPI number — RACHEL J MORRISEY PH.D.

Table of content: RACHEL J MORRISEY PH.D. (NPI 1861540015)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861540015 NPI number — RACHEL J MORRISEY PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORRISEY
Provider First Name:
RACHEL
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861540015
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2200 FORT ROOTS DRIVE (116B/NLR)
Provider Second Line Business Mailing Address:
CENTRAL ARKANSAS VETERANS HEALTHCARE SYSTEM
Provider Business Mailing Address City Name:
LITTLE ROCK
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72114
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-321-3600
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 FORT ROOTS DRIVE (116B/NLR)
Provider Second Line Business Practice Location Address:
CENTRAL ARKANSAS VETERANS HEALTHCARE SYSTEM
Provider Business Practice Location Address City Name:
LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-321-3600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/06/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  2349-057 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 39134300 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".