Provider Demographics
NPI:1669090833
Name:MORTON, DAVID A (RN)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:A
Last Name:MORTON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13529 HICKORY DR
Mailing Address - Street 2:
Mailing Address - City:NEOSHO
Mailing Address - State:MO
Mailing Address - Zip Code:64850-6136
Mailing Address - Country:US
Mailing Address - Phone:417-389-0438
Mailing Address - Fax:
Practice Address - Street 1:13529 HICKORY DR
Practice Address - Street 2:
Practice Address - City:NEOSHO
Practice Address - State:MO
Practice Address - Zip Code:64850-6136
Practice Address - Country:US
Practice Address - Phone:417-389-0438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000163213163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine