MEDICARE: MS. AURA MERCEDES MORENO PMHNP

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	163WP0808X	Psychiatric/Mental Health Registered Nurse	RN138995	AZ
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP2419	AZ
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	TP006641	PA

General Provider Information

NPI Number	:	1891807665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AURA MERCEDES MORENO PMHNP

Provider Business Mailing Address
First Line	:	2 SUTPHIN PNES
Second Line	:
City	:	YARDLEY
State	:	PA
Zip	:	19067-3461
Country	:	US
Telephone Number	:	484-714-9866
Fax Number	:

Provider Business Practice Location Address
First Line	:	635 E BROAD ST
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18018-6332
Country	:	US
Telephone Number	:	610-984-1380
Fax Number	:	833-908-2291

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	12/24/2022

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