Provider Demographics
NPI:1073163036
Name:MORAN, CEIRRA KAY
Entity Type:Individual
Prefix:MS
First Name:CEIRRA
Middle Name:KAY
Last Name:MORAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CEIRRA
Other - Middle Name:KAY
Other - Last Name:MOSES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1410 E HILL AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-2545
Mailing Address - Country:US
Mailing Address - Phone:918-312-0287
Mailing Address - Fax:
Practice Address - Street 1:2325 S HARVARD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-3300
Practice Address - Country:US
Practice Address - Phone:918-312-0287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator