Sandra Kay Moreo, LPN

Individual provider Active NPI Licensed Practical Nurse · Continental, OH

NPI 1003214644 · NPPES record last updated Dec 14, 2014

Key facts

NPI
1003214644
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN.139149-M-IV (OH)
Practice address
207 N River St
Continental, OH 45831-8952
Phone
(419) 969-0685
NPI assigned
Dec 14, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN.139149-M-IVOHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN.139149-M-IV OH Yes

Addresses

Primary practice location

207 N River St
Continental, OH 45831-8952

Mailing address

207 N River St
Continental, OH 45831-8952
Phone (419) 969-0685

Other identifiers

IdentifierTypeStateIssuer
PN.139149-M-IVMedicaidOH

Other providers in Continental, OH

All providers in Continental, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.