Provider Demographics
NPI:1912916875
Name:MORTON, LINDA SUE (RD,LD)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:SUE
Last Name:MORTON
Suffix:
Gender:F
Credentials:RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-2370
Mailing Address - Country:US
Mailing Address - Phone:417-334-7118
Mailing Address - Fax:
Practice Address - Street 1:103 E.MAIN ST.
Practice Address - Street 2:BRANSON DRUG,
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-2713
Practice Address - Country:US
Practice Address - Phone:417-334-3187
Practice Address - Fax:417-334-3309
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20010008561133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered