Provider Demographics
NPI:1255196598
Name:MORELAND, AIDAN (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:AIDAN
Middle Name:
Last Name:MORELAND
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 W 175TH ST S
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:KS
Mailing Address - Zip Code:67022-8301
Mailing Address - Country:US
Mailing Address - Phone:620-845-6492
Mailing Address - Fax:
Practice Address - Street 1:761 W 175TH ST S
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:KS
Practice Address - Zip Code:67022-8301
Practice Address - Country:US
Practice Address - Phone:620-845-6492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-82905-112363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily