Provider Demographics
NPI:1083832448
Name:MORTON, AMY LEE (APN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LEE
Last Name:MORTON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 GREENWAY PLZ STE 2950
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046-0924
Mailing Address - Country:US
Mailing Address - Phone:713-580-9463
Mailing Address - Fax:
Practice Address - Street 1:3919 N MALL AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4906
Practice Address - Country:US
Practice Address - Phone:479-444-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03110ANP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner