Provider Demographics
NPI:1326630898
Name:DEBRA R. MORTON
Entity Type:Organization
Organization Name:DEBRA R. MORTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:703-919-2439
Mailing Address - Street 1:911 PORTNER PL
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-1313
Mailing Address - Country:US
Mailing Address - Phone:703-919-2439
Mailing Address - Fax:
Practice Address - Street 1:4509 WHITECHAPEL DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6447
Practice Address - Country:US
Practice Address - Phone:703-919-2439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-06
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty