Individual
JUDY AIVETTE MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP-FAMILY
Contact information
Practice address
301 SAINT PAUL ST, BALTIMORE, MD 21202-2102
(410) 332-9407
(410) 332-9789
Mailing address
4513 GINA CT, BALTIMORE, MD 21237-3702
(410) 530-5048
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R176392
MD
Other
Enumeration date
05/29/2019
Last updated
05/29/2019
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