Provider Demographics
NPI:1164611158
Name:MORFORD, LADEAN MARIE (RN)
Entity Type:Individual
Prefix:MS
First Name:LADEAN
Middle Name:MARIE
Last Name:MORFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:LOWER BRULE
Mailing Address - State:SD
Mailing Address - Zip Code:57548-0248
Mailing Address - Country:US
Mailing Address - Phone:605-473-8252
Mailing Address - Fax:605-473-5677
Practice Address - Street 1:601 GALL STREET
Practice Address - Street 2:
Practice Address - City:LOWER BRULE
Practice Address - State:SD
Practice Address - Zip Code:57548
Practice Address - Country:US
Practice Address - Phone:605-473-8252
Practice Address - Fax:605-473-5677
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR018575163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse