Provider Demographics
NPI:1639715295
Name:MORTON, VICTORIA LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LYNN
Last Name:MORTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:LYNN
Other - Last Name:BUENO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:6102 W ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-0007
Mailing Address - Country:US
Mailing Address - Phone:254-252-5757
Mailing Address - Fax:903-532-1401
Practice Address - Street 1:6102 W ADAMS AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-0007
Practice Address - Country:US
Practice Address - Phone:254-252-5757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC82218164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse