Individual
MRS. MISTY MARIE MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 CHILDRENS WAY, SLOT 203, LITTLE ROCK, AR 72202-3500
(501) 364-2938
(501) 364-2939
Mailing address
1 CHILDREN'S WAY, #653, LITTLE ROCK, AR 72202-5061
(501) 364-1100
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
PENDING
AR
Other
Enumeration date
03/30/2017
Last updated
06/27/2017
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