Individual provider · Type 1 NPI
Stacia Lark Moreno, NP
Family Nurse Practitioner · Baltimore, MD
NPI number
1629774567
Active
Practice location
1501 Division St
Baltimore, MD 21217-3121
Mailing address
7789 Arundel Mills Blvd Apt 311
Hanover, MD 21076-2020
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | R225927 (MD) |
Family Nurse Practitioner: Definition to come...
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About NPI 1629774567
Stacia Lark Moreno, NP's National Provider Identifier is 1629774567, issued on Feb 2, 2023. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Baltimore, MD. The record was last updated on Mar 8, 2023.