Individual
JACQUELINE LINDA MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
231 E CHESTNUT ST, LOUISVILLE, KY 40202-1821
(502) 629-6000
Mailing address
PO BOX 713350, CHICAGO, IL 60677-1392
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3015965
KY
367500000X
Certified Registered Nurse Anesthetist
ARNP9193933
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3015965
KY STATE LICENSE
KY
Enumeration date
10/17/2011
Last updated
07/03/2023
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