Individual
VICKY JO MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
349 E CORONADO RD, PHOENIX, AZ 85004-1525
(602) 266-5678
Mailing address
349 E CORONADO RD, PHOENIX, AZ 85004-1525
(602) 266-5678
(770) 559-1231
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
251502
AZ
367500000X
Certified Registered Nurse Anesthetist
RN103578
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126677
—
MS
05
—
1143073
—
LA
Enumeration date
05/05/2006
Last updated
06/21/2021
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