Individual
NANCY C. MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4721 S CLIFF AVE, SUITE 200, INDEPENDENCE, MO 64055-7016
(816) 503-3700
(816) 503-3723
Mailing address
4721 S CLIFF AVE, SUITE 200, INDEPENDENCE, MO 64055-7016
(816) 503-3700
(816) 503-3723
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
103373
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080181189
RR MEDICARE
—
01
—
10001640101
CHP PROVIDER NUMBER FCI
—
01
—
10001640102
CHP PROVIDER NUMBER PHFUC
—
01
—
18960020
CFU BCBS
—
01
—
20916093
BCBS
—
01
—
22039026
BCBS PHF URGENT CARE
—
01
—
4528879
AETNA
—
01
—
481159444
JAYHAWK TAX ID
—
Enumeration date
06/14/2006
Last updated
11/03/2009
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