Provider Demographics
NPI:1124309133
Name:MORNINGSTAR, ANN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:
Last Name:MORNINGSTAR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4315 W MORNING MIST DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-6385
Mailing Address - Country:US
Mailing Address - Phone:479-856-3564
Mailing Address - Fax:
Practice Address - Street 1:4007 N SHILOH DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5300
Practice Address - Country:US
Practice Address - Phone:479-442-4756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD08755183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist