Provider Demographics
NPI:1295618742
Name:MORAN, CARLOS GABRIEL (APRN, FNP-BC)
Entity type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:GABRIEL
Last Name:MORAN
Suffix:
Gender:M
Credentials: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 1:16 REYBURN DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-3349
Mailing Address - Country:US
Mailing Address - Phone:909-632-6121
Mailing Address - Fax:
Practice Address - Street 1:16 REYBURN DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-3349
Practice Address - Country:US
Practice Address - Phone:909-632-6121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV835442363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily