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NPI Code Detail

MEDICARE: TINA P MORTON

MEDICARE: TINA P MORTON
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
12472B0301XBiomedical Engineering Technician
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1548606627
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA P MORTON
Provider Business Mailing Address
First Line : 305 BONANZA WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-2014
Country : US
Telephone Number : 702-279-4475
Fax Number :
Provider Business Practice Location Address
First Line : 5659 DUNCAN DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-2811
Country : US
Telephone Number : 702-290-7128
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2013
Last Update Date : 06/26/2013

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Directions to “ TINA P MORTON ” Practice Location

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