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General NPI Number Information
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NPI Number | 1588255038
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Entity Type | Individual
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Provider Name | LATEIAH MORTON RN
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Gender | Female
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Dates
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Enumeration Date | 01/28/2021
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | 1736 MAIN ST S
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City | GREENWOOD
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State | SC
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Zip | 29646-4100
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Country | US
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Telephone | 864-942-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 351 BRADLEY RD
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City | MC CORMICK
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State | SC
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Zip | 29835-6529
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Country | US
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Telephone | 864-554-5102
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 241789
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License Number State | SC
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