MEDICARE: PATRICIA C 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
1	363LF0000X	Family Nurse Practitioner	24739	TN

General Provider Information

NPI Number	:	1043790843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA C MORTON NP

Provider Business Mailing Address
First Line	:	PO BOX 440295
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37244-0295
Country	:	US
Telephone Number	:	865-670-6199
Fax Number	:	865-670-6198

Provider Business Practice Location Address
First Line	:	5779 CREEKWOOD PARK BLVD STE 110
Second Line	:
City	:	LENOIR CITY
State	:	TN
Zip	:	37772-1203
Country	:	US
Telephone Number	:	865-635-2810
Fax Number	:	865-635-2812

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

Provider Enumeration Date	:	08/21/2018
Last Update Date	:	09/11/2018

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