MEDICARE: LISA MARIE ORTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	2021034085	MO
2	363LF0000X	Family Nurse Practitioner	209020716	IL

General Provider Information

NPI Number	:	1386274843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA MARIE ORTON

Provider Business Mailing Address
First Line	:	6500 HOSPITAL DR
Second Line	:
City	:	HANNIBAL
State	:	MO
Zip	:	63401-6890
Country	:	US
Telephone Number	:	573-248-5401
Fax Number	:	573-248-5419

Provider Business Practice Location Address
First Line	:	821 US HIGHWAY 24 36 E
Second Line	:
City	:	MONROE CITY
State	:	MO
Zip	:	63456-1470
Country	:	US
Telephone Number	:	573-735-2506
Fax Number	:	573-735-1088

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2020
Last Update Date	:	03/13/2025

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Directions to “ LISA MARIE ORTON ” Practice Location

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