Provider Demographics
NPI:1982826178
Name:MORAN, JANE MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:MARIE
Last Name:MORAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10830 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 310
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-1050
Mailing Address - Country:US
Mailing Address - Phone:972-241-6891
Mailing Address - Fax:972-241-2891
Practice Address - Street 1:10830 N CENTRAL EXPY
Practice Address - Street 2:SUITE 310
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-1050
Practice Address - Country:US
Practice Address - Phone:972-241-6891
Practice Address - Fax:972-241-2891
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX592815363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ19884Medicare UPIN
TX8C9968Medicare ID - Type Unspecified