MEDICARE: KARI JEAN MOELLER FNP

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
1	364SF0001X	Family Health Clinical Nurse Specialist	95003609	CA
2	363LF0000X	Family Nurse Practitioner	95003609	CA

General Provider Information

NPI Number	:	1841656980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARI JEAN MOELLER FNP

Provider Business Mailing Address
First Line	:	72047 DINAH SHORE DR STE C4
Second Line	:
City	:	RANCHO MIRAGE
State	:	CA
Zip	:	92270-1783
Country	:	US
Telephone Number	:	760-770-7600
Fax Number	:	760-770-0500

Provider Business Practice Location Address
First Line	:	71687 HIGHWAY 111 STE 101
Second Line	:
City	:	RANCHO MIRAGE
State	:	CA
Zip	:	92270-4515
Country	:	US
Telephone Number	:	760-341-0772
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2016
Last Update Date	:	05/31/2024

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