Provider Demographics
NPI:1174521884
Name:MORALES, ANN C (NP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:C
Last Name:MORALES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 DOGWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-3312
Mailing Address - Country:US
Mailing Address - Phone:720-297-0834
Mailing Address - Fax:
Practice Address - Street 1:8030 IRVING ST.
Practice Address - Street 2:KIDS FIRST HEALTH CARE
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031
Practice Address - Country:US
Practice Address - Phone:303-428-4384
Practice Address - Fax:720-542-4027
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO49362363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07493620Medicaid
CO07493620Medicaid