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General NPI Number Information
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NPI Number | 1639767908
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Entity Type | Individual
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Provider Name | KATIE MORAN FNP
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Gender | Female
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Dates
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Enumeration Date | 01/04/2021
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 5905 US 301 S
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City | RIVERVIEW
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State | FL
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Zip | 33578-3800
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Country | US
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Telephone | 727-822-7115
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Fax |
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Provider Business Mailing Address
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Address Line | 12103 NIGHT JASMINE CV
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City | RIVERVIEW
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State | FL
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Zip | 33579-9319
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Country | US
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Telephone | 954-806-8267
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11012356
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9563869
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License Number State | FL
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