Provider Demographics
NPI:1487289344
Name:MORONES, MARANDA ALYSE (RN)
Entity type:Individual
Prefix:MRS
First Name:MARANDA
Middle Name:ALYSE
Last Name:MORONES
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:232 VZ COUNTY ROAD 3412
Mailing Address - Street 2:
Mailing Address - City:WILLS POINT
Mailing Address - State:TX
Mailing Address - Zip Code:75169-7813
Mailing Address - Country:US
Mailing Address - Phone:214-502-2870
Mailing Address - Fax:
Practice Address - Street 1:8200 WALNUT HILL LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4402
Practice Address - Country:US
Practice Address - Phone:214-345-2647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-10
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX712932163WN0002X
TXAP145767363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care