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NPI Code Detail

MEDICARE: MRS. KIMBERLY MICHELLE MORTON NP

MEDICARE: MRS. KIMBERLY MICHELLE MORTON NP
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
1363L00000XNurse Practitioner121777NC
2363LF0000XFamily Nurse Practitioner960056NC
3363L00000XNurse Practitioner960056NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1118075OTHERNCMEDICAL BOARD
2121777OTHERNCBOARD OF NURSING

General Provider Information

NPI Number : 1023086972
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMBERLY MICHELLE MORTON NP
Provider Business Mailing Address
First Line : 1309 LEES CHAPEL RD
Second Line :
City : GREENSBORO
State : NC
Zip : 27455-2601
Country : US
Telephone Number : 336-286-5505
Fax Number : 336-286-5583
Provider Business Practice Location Address
First Line : 1309 LEES CHAPEL RD
Second Line :
City : GREENSBORO
State : NC
Zip : 27455-2601
Country : US
Telephone Number : 336-286-5505
Fax Number : 336-286-5583
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2006
Last Update Date : 06/28/2024

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