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General NPI Number Information
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NPI Number | 1134924376
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Entity Type | Individual
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Provider Name | JENNIFER MORENO AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 1200 E RIDGE RD STE 6
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City | MCALLEN
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State | TX
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Zip | 78503-1528
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Country | US
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Telephone | 956-331-8150
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 E RIDGE RD. STE 6.
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City | MCALLEN
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State | TX
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Zip | 78503
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Country | US
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Telephone | 956-331-8150
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 1026872
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License Number State | TX
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