Individual
MATTHEW MOREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
795 EASTERN BYP, BLDG 2 STE 6, RICHMOND, KY 40475-2406
(859) 625-1879
Mailing address
317 SAVANNA DR, RICHMOND, KY 40475-7513
(859) 582-3840
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3004199
KY
367500000X
Certified Registered Nurse Anesthetist
COA.08833-NA
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2690262
—
OH
05
—
74006750
—
KY
Enumeration date
08/12/2005
Last updated
02/03/2016
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