Provider Demographics
NPI:1083272793
Name:MORTON, MARIA (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:MORTON
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MELISSA DR
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-1221
Mailing Address - Country:US
Mailing Address - Phone:678-755-7369
Mailing Address - Fax:
Practice Address - Street 1:40 MELISSA DR
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-1221
Practice Address - Country:US
Practice Address - Phone:678-755-7369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN194509163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse