Healthcare Provider Details

I. General information

NPI: 1841891637
Provider Name (Legal Business Name): CECILEE MARIE MORAY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2020
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3111 COLUMBIA ST.
KAMLOOPS BC
V2E1L3
CA

IV. Provider business mailing address

2086 HIGH COUNTRY BLVD
KAMLOOPS BC
V2E1L3
CA

V. Phone/Fax

Practice location:
  • Phone: 250-374-5111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4081029-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: