DEANNA MOORMAN FNP-BC NPI 1134537632

NPI Information

  • NPI: 1134537632
  • Provider Name: DEANNA MOORMAN, FNP-BC
  • Classification: Nurse Practitioner - 363LX0001X
  • Specialization: Obstetrics & Gynecology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2023 VADALABENE DR
    SUITE 200
    MARYVILLE, IL
    ZIP 62062
  • Phone: (618) 288-7408

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NPI Details

Deanna Moorman, FNP-BC is an obstetrics and gynecology nurse practitioner in Maryville, IL. Deanna Moorman, FNP-BC NPI is 1134537632. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2023 VADALABENE DR
SUITE 200
MARYVILLE, IL
ZIP 62062-630
Phone: (618) 288-7408

The NPI 1134537632 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/28/2014 and was last updated on 10/15/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse Practitioner209011286ILLINOISNo
2363LX0001XNurse PractitionerObstetrics & Gynecology209011286ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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