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Individual

ANGIE MOON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
10808 FORT ST, OMAHA, NE 68164
(888) 333-7520
Mailing address
7261 MERCY RD, OMAHA, NE 68124-2311

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
68085
NE
363LF0000X
Family Nurse Practitioner
Primary
112481
NE

Other

Enumeration date
04/04/2018
Last updated
06/20/2018
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