Provider Demographics
NPI:1235455452
Name:MORAN, GISELA (RN, WCC)
Entity Type:Individual
Prefix:MRS
First Name:GISELA
Middle Name:
Last Name:MORAN
Suffix:
Gender:F
Credentials:RN, WCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3229 VARNELL DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-3634
Mailing Address - Country:US
Mailing Address - Phone:850-656-9207
Mailing Address - Fax:
Practice Address - Street 1:3229 VARNELL DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-3634
Practice Address - Country:US
Practice Address - Phone:850-656-9207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-13
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9259891163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007712000Medicaid