1346260320 NPI number — MRS. JANEL SHARP MORENO ARNP

Table of content: MRS. JANEL SHARP MORENO ARNP (NPI 1346260320)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346260320 NPI number — MRS. JANEL SHARP MORENO ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORENO
Provider First Name:
JANEL
Provider Middle Name:
SHARP
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHARP
Provider Other First Name:
JANEL
Provider Other Middle Name:
JAYME
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1346260320
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
559 VINCENT ST
Provider Second Line Business Mailing Address:
ATTN: 21 MDDS/SGOF - FAM HLTH
Provider Business Mailing Address City Name:
PETERSON AFB
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80914-1541
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-526-2273
Provider Business Mailing Address Fax Number:
877-813-1756

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
559 VINCENT ST
Provider Second Line Business Practice Location Address:
ATTN: 21 MDDS/SGOF - FAM HLTH
Provider Business Practice Location Address City Name:
PETERSON AFB
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80914-1541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-526-2273
Provider Business Practice Location Address Fax Number:
877-813-1756
Provider Enumeration Date:
07/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  .0991000 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)