Provider Demographics
NPI:1396976387
Name:MORTON, JANICE LYNNE (LPN)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:LYNNE
Last Name:MORTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3738 W MORTEN AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-6454
Mailing Address - Country:US
Mailing Address - Phone:602-589-7690
Mailing Address - Fax:
Practice Address - Street 1:3738 W MORTEN AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-6454
Practice Address - Country:US
Practice Address - Phone:602-589-7690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-07
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPO12971164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse