Individual
NICOLE MORTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5925 BRADFORD DR, SUFFOLK, VA 23435-2001
(757) 855-6457
Mailing address
5925 BRADFORD DR, SUFFOLK, VA 23435-2001
(757) 610-7748
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
3747A0650X
Attendant Care Provider
—
—
376K00000X
Nurse's Aide
Primary
1401100481
VA
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134396005
—
VA
Enumeration date
05/10/2008
Last updated
10/24/2018
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