Provider Demographics
NPI:1679867741
Name:MORAN, FLORENCE CHRISTINE (RD LMNT)
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:CHRISTINE
Last Name:MORAN
Suffix:
Gender:F
Credentials:RD LMNT
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:F
Other - Last Name:MORAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD LMNT
Mailing Address - Street 1:713 S 25TH ST
Mailing Address - Street 2:
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310-4179
Mailing Address - Country:US
Mailing Address - Phone:610-823-3574
Mailing Address - Fax:
Practice Address - Street 1:1110 N 10TH ST
Practice Address - Street 2:
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310-2039
Practice Address - Country:US
Practice Address - Phone:402-481-7387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE993133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered