Provider Demographics
NPI:1053363200
Name:MORTON, DANA E (ARNP)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:E
Last Name:MORTON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 SOUTHERN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:COFFEYVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67337-9623
Mailing Address - Country:US
Mailing Address - Phone:316-992-1591
Mailing Address - Fax:
Practice Address - Street 1:302 SOUTHERN HILLS DR
Practice Address - Street 2:
Practice Address - City:COFFEYVILLE
Practice Address - State:KS
Practice Address - Zip Code:67337-9623
Practice Address - Country:US
Practice Address - Phone:316-992-1591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS74308363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100447400AMedicaid
KS100447400AMedicaid
R31612Medicare UPIN