Provider Demographics
NPI:1376004051
Name:MORALES-CARABALLO, ANNA (DNP,CRNP,FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:MORALES-CARABALLO
Suffix:
Gender:F
Credentials:DNP,CRNP,FNP-BC
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:MORALES-CARABALLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:133 W HUNTING PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-2717
Mailing Address - Country:US
Mailing Address - Phone:215-324-0600
Mailing Address - Fax:
Practice Address - Street 1:133 W HUNTING PARK AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140
Practice Address - Country:US
Practice Address - Phone:215-324-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2018089666363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily