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General NPI Number Information
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NPI Number | 1417494840
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Entity Type | Individual
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Provider Name | RENATA ARAUJO MOEN APRN
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Gender | Female
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Dates
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Enumeration Date | 01/24/2017
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 14540 OLD SAINT AUGUSTINE RD STE 2403
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City | JACKSONVILLE
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State | FL
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Zip | 32258-7418
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Country | US
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Telephone | 904-253-6910
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Fax | 904-253-6964
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Provider Business Mailing Address
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Address Line | 1443 SAN MARCO BLVD STE 101
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8535
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Country | US
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Telephone | 904-253-6910
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Fax | 904-253-6964
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9316187
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN9316187
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License Number State | FL
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