Provider Demographics
NPI:1568298925
Name:MORENO, OSCAR (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:MR
First Name:OSCAR
Middle Name:
Last Name:MORENO
Suffix:
Gender:M
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 VERMILLION DR
Mailing Address - Street 2:
Mailing Address - City:CANUTILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79835-5020
Mailing Address - Country:US
Mailing Address - Phone:915-630-5231
Mailing Address - Fax:
Practice Address - Street 1:823 E YANDELL DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5331
Practice Address - Country:US
Practice Address - Phone:915-545-7205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1174583363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily