Moran, Judith Anne

Moran, Judith Anne is an individual health care provider with primary practice located at 10010 Kennerly Rd , Saint Louis MO 63128-2106. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Moran, Judith Anne can be contacted via phone (636) 386-7222.

Contact Information

Primary practice address
10010 Kennerly Rd Saint Louis MO 63128-2106
Phone: (636) 386-7222
Fax: (636) 386-7810
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X C01016 Arkansas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APN0000010072 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 128948 Missouri

Profile Details

NPI number 1710971908
LBN Legal business name Moran, Judith Anne
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2005
Last updated Feb 12th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710971908 NPPES
Arkansas MEDICAID 143653701
Arkansas Other 4068895
Arkansas MEDICAID 3629651
Arkansas MEDICAID 911331007
Arkansas Other 900418777
Arkansas Other 5T743

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