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General NPI Number Information
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NPI Number | 1174366314
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Entity Type | Individual
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Provider Name | NICHOLE MORTON MHA,BSN,RN-BC
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Gender | Female
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Dates
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Enumeration Date | 06/17/2024
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | 8530 TOWNSHIP LINE RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46260
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Country | US
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Telephone | 463-999-9045
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Fax |
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Provider Business Mailing Address
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Address Line | 1187 PINEWOOD DR
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City | PLAINFIELD
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State | IN
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Zip | 46168-2487
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Country | US
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Telephone | 812-240-3526
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28183233A
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License Number State | IN
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