Provider Demographics
NPI:1841656980
Name:MOELLER, KARI JEAN (FNP)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:JEAN
Last Name:MOELLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72047 DINAH SHORE DR STE C4
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1783
Mailing Address - Country:US
Mailing Address - Phone:760-770-7600
Mailing Address - Fax:760-770-0500
Practice Address - Street 1:71687 HIGHWAY 111 STE 101
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4515
Practice Address - Country:US
Practice Address - Phone:760-341-0772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-05
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003609364SF0001X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health