Healthcare Provider Details

I. General information

NPI: 1932107612
Provider Name (Legal Business Name): MORAN NURSING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 10/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3940 HIGHWAY 54
MORAN KS
66755-3921
US

IV. Provider business mailing address

3940 HIGHWAY 54
MORAN KS
66755-3921
US

V. Phone/Fax

Practice location:
  • Phone: 620-237-4309
  • Fax: 620-237-4446
Mailing address:
  • Phone: 620-237-4309
  • Fax: 620-237-4446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberN001003
License Number StateKS

VIII. Authorized Official

Name: MR. JAMES REIKER
Title or Position: TREASURER
Credential:
Phone: 573-471-1113