Individual
KATHLEEN M MORAGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
1720 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 234-4171
(701) 461-5649
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-2119
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
R21662
ND
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
R21662
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
285471600
—
MN
05
—
70022
—
ND
Enumeration date
07/17/2006
Last updated
02/01/2013
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