Active NPI
Kristal Lynn Moran
- Registered Nurse
- Clinton, MO
National Provider Identifier
1265614176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 2005004021
- Practice address
- 1600 N Second St
Clinton, MO 64735 - Phone
- (660) 885-5511
- Fax
- (660) 885-8496
- NPI assigned
- Dec 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2005004021 | MO | Primary |
Addresses
Primary practice location
1600 N Second St
Clinton, MO 64735
Mailing address
1600 N Second St
Clinton, MO 64735
Phone (660) 885-5511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005004021 | MO | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196640000000",
"number": "1265614176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 N SECOND ST",
"city": "CLINTON",
"state": "MO",
"postal_code": "64735",
"telephone_number": "660-885-5511",
"fax_number": "660-885-8496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 N SECOND ST",
"city": "CLINTON",
"state": "MO",
"postal_code": "64735",
"telephone_number": "660-885-5511",
"fax_number": "660-885-8496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "KRISTAL",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-03",
"last_updated": "2007-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "2005004021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.