Provider Demographics
NPI:1841411725
Name:MORAZAN, ARACELLY (RNP)
Entity type:Individual
Prefix:
First Name:ARACELLY
Middle Name:
Last Name:MORAZAN
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3512 E FLORENCE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-5900
Mailing Address - Country:US
Mailing Address - Phone:323-582-1180
Mailing Address - Fax:323-582-8280
Practice Address - Street 1:3512 E FLORENCE AVE STE 102
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-5900
Practice Address - Country:US
Practice Address - Phone:235-821-1803
Practice Address - Fax:323-582-8280
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARNP 17046363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN568522Medicaid
CANP 17046OtherNURSE PRACTITIONER