Provider Demographics
NPI:1588255038
Name:MORTON, LATEIAH (RN)
Entity type:Individual
Prefix:
First Name:LATEIAH
Middle Name:
Last Name:MORTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 BRADLEY RD
Mailing Address - Street 2:
Mailing Address - City:MC CORMICK
Mailing Address - State:SC
Mailing Address - Zip Code:29835-6529
Mailing Address - Country:US
Mailing Address - Phone:864-554-5102
Mailing Address - Fax:
Practice Address - Street 1:1736 MAIN ST S
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-4100
Practice Address - Country:US
Practice Address - Phone:864-942-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC241789163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health