Individual
MS. SANDRA MORENO-CHRISTIANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, WHNP
Contact information
Practice address
3320 LIVE OAK ST, 5TH FLOOR, DALLAS, TX 75204-6109
(214) 266-1200
Mailing address
1620 HURON TRL, PLANO, TX 75075-6708
(972) 841-2104
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
244159
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10007060
AMERIGROUP ID #
TX
05
—
139696218
—
TX
01
—
244159
STATE LICENSE
TX
01
—
89N734
BLUE CROSS &BLUE SHIELD
TX
Enumeration date
07/20/2006
Last updated
10/01/2014
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