Provider Demographics
NPI:1457085532
Name:MORTON, KATHLEEN (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:MORTON
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 GLENBROOK RD APT 513
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2875
Mailing Address - Country:US
Mailing Address - Phone:860-987-7613
Mailing Address - Fax:
Practice Address - Street 1:219 BAYBERRY LN
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-1605
Practice Address - Country:US
Practice Address - Phone:646-838-1384
Practice Address - Fax:203-286-1341
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2024029569363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily