MEDICARE: JANE MARIE MORAN FNP-C

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	363LF0000X	Family Nurse Practitioner	592815	TX

General Provider Information

NPI Number	:	1982826178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE MARIE MORAN FNP-C

Provider Business Mailing Address
First Line	:	10830 N CENTRAL EXPY
Second Line	:	SUITE 310
City	:	DALLAS
State	:	TX
Zip	:	75231-1050
Country	:	US
Telephone Number	:	972-241-6891
Fax Number	:	972-241-2891

Provider Business Practice Location Address
First Line	:	10830 N CENTRAL EXPY
Second Line	:	SUITE 310
City	:	DALLAS
State	:	TX
Zip	:	75231-1050
Country	:	US
Telephone Number	:	972-241-6891
Fax Number	:	972-241-2891

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	08/24/2016

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