Provider Demographics
NPI:1801072350
Name:MORTON, PATRICIA WYNETTE (LPN)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:WYNETTE
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 1:2122 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4430
Mailing Address - Country:US
Mailing Address - Phone:931-490-1480
Mailing Address - Fax:931-490-1482
Practice Address - Street 1:2122 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4430
Practice Address - Country:US
Practice Address - Phone:931-490-1480
Practice Address - Fax:931-490-1482
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000036659101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health