Individual
KETAN J MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
316 MANATEE AVE W, BRADENTON, FL 34205
(941) 748-2277
Mailing address
367 S. GULPH ROAD, ATTN: IPM CREDENTIALING, KING OF PRUSSIA, PA 19406-3121
(941) 748-2277
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9410779
FL
Other
Enumeration date
05/05/2018
Last updated
06/04/2018
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