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NPI Code Detail

MEDICARE: MR. BETTY M MORTON LPN

MEDICARE: MR. BETTY M MORTON LPN
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
1164W00000XLicensed Practical NurseL0051161OK

General Provider Information

NPI Number : 1073727608
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BETTY M MORTON LPN
Provider Business Mailing Address
First Line : 8312 TIMOTHY LN
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73135-6039
Country : US
Telephone Number : 405-249-2494
Fax Number :
Provider Business Practice Location Address
First Line : 1215 NW 25TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-5629
Country : US
Telephone Number : 405-525-2525
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 07/08/2007

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Directions to “ MR. BETTY M MORTON LPN” Practice Location

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