Individual
PATRICIA MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
7 SHACKLEFORD WEST BLVD, LITTLE ROCK, AR 72211-3886
(501) 664-5860
Mailing address
7 SHACKLEFORD WEST BLVD, LITTLE ROCK, AR 72211-3886
(501) 664-5860
(501) 664-0889
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A004378
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A004378
STATE LICENSE
AR
Enumeration date
04/24/2015
Last updated
10/31/2022
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