Individual
KEVIN MORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN BSN
Contact information
Practice address
215 PINE KNOTT RD, FAYETTEVILLE, GA 30214-3249
(404) 933-7234
Mailing address
215 PINE KNOTT RD, FAYETTEVILLE, GA 30214-3249
(404) 933-7234
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
RN215073
GA
Other
Enumeration date
03/14/2024
Last updated
03/14/2024
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