Provider Demographics
NPI:1710296553
Name:MORENO, SHARON DENISE (RN-BC, FNP-C)
Entity Type:Individual
Prefix:MISS
First Name:SHARON
Middle Name:DENISE
Last Name:MORENO
Suffix:
Gender:F
Credentials:RN-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:506 MANGO LN
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-7313
Mailing Address - Country:US
Mailing Address - Phone:966-640-6963
Mailing Address - Fax:
Practice Address - Street 1:165 S 6TH ST
Practice Address - Street 2:
Practice Address - City:RAYMONDVILLE
Practice Address - State:TX
Practice Address - Zip Code:78580-3521
Practice Address - Country:US
Practice Address - Phone:956-689-5506
Practice Address - Fax:956-689-1988
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX708010363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily