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NPI Code Detail

MEDICARE: JENNIFER MORAN ARNP

MEDICARE: JENNIFER MORAN ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerAO96033IA
2363L00000XNurse PractitionerAPN.0993856-NPCO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831107085
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER MORAN ARNP
Provider Business Mailing Address
First Line : PO BOX 732031
Second Line :
City : DALLAS
State : TX
Zip : 75373-2031
Country : US
Telephone Number : 866-429-6045
Fax Number : 970-495-8910
Provider Business Practice Location Address
First Line : 4650 SIGNAL TREE DR STE 1200
Second Line :
City : TIMNATH
State : CO
Zip : 80547-4908
Country : US
Telephone Number : 970-237-7415
Fax Number : 970-237-7420
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2006
Last Update Date : 01/10/2022

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