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NPI Code Detail

MEDICARE: TARA D MORTON APRN

MEDICARE:   TARA D MORTON  APRN
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
1363LA2100XAcute Care Nurse Practitioner111183NE

General Provider Information

NPI Number : 1508175894
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA D MORTON APRN
Provider Business Mailing Address
First Line : 1397 CALLAHAN DR
Second Line :
City : COUNCIL BLUFFS
State : IA
Zip : 51503-2573
Country : US
Telephone Number : 402-250-7211
Fax Number :
Provider Business Practice Location Address
First Line : 4350 DEWEY AVE
Second Line :
City : OMAHA
State : NE
Zip : 68105-1017
Country : US
Telephone Number : 402-552-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2010
Last Update Date : 08/31/2016

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Directions to “ TARA D MORTON APRN” Practice Location

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