Provider Demographics
NPI:1487128591
Name:MOONEY, MORGAN RAE (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:RAE
Last Name:MOONEY
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:RAE
Other - Last Name:LENT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, APRN, FNP-C
Mailing Address - Street 1:3110 N RIDGE RD APT 306
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1245
Mailing Address - Country:US
Mailing Address - Phone:316-841-6022
Mailing Address - Fax:
Practice Address - Street 1:3110 N RIDGE RD APT 306
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1245
Practice Address - Country:US
Practice Address - Phone:316-841-6022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-11
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5378527022363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily