Provider Demographics
NPI:1033258645
Name:MORAN, CHRISTINE REED (CRNP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:REED
Last Name:MORAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 CEDARBROOK RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-4156
Mailing Address - Country:US
Mailing Address - Phone:215-355-7036
Mailing Address - Fax:
Practice Address - Street 1:1844 STREET RD
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-4582
Practice Address - Country:US
Practice Address - Phone:215-357-4066
Practice Address - Fax:215-364-2572
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP006700B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP3821Medicare UPIN