Individual provider Active NPI

Evelyn Maritza Moreno, RNFA

  • Registered Nurse First Assistant
  • Mansfield, TX
National Provider Identifier
1295246908
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
10300778 Issued in TX
Practice address
4313 Stonebriar TRL
Mansfield, TX 76063-5871
Phone
(626) 999-7696
NPI assigned
Oct 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 10300778 TX Primary

Addresses

Primary practice location

4313 Stonebriar TRL
Mansfield, TX 76063-5871

Mailing address

4313 Stonebriar TRL
Mansfield, TX 76063-5871
Phone (626) 999-7696

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

LicenseStateTypeSpecialty
10300778TXMDRegistered Nurse First Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1295246908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4313 STONEBRIAR TRL",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635871",
            "telephone_number": "626-999-7696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4313 STONEBRIAR TRL",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635871",
            "telephone_number": "626-999-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "EVELYN",
        "middle_name": "MARITZA",
        "credential": "RNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-20",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "TX",
            "license": "10300778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.