MS. NOREEN TRESA JACK-MOONEY (NPI# 1831105287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831105287 |
| Entity Type | Individual |
| Full Name | MS. NOREEN TRESA JACK-MOONEY |
| Other Name | MS. NOREEN TRESA JACK-MOONEY |
| Credential | PA-C |
| Practice Address |
80 B Veterans Blvd I-40, Exit 102 Acoma NM 87034 |
| Mailing Address |
2050 S Blosser Rd Santa Maria CA 93458-7310 |
| Practice Telephone | 5055525300 |
| Practice Fax Number | 5055525828 |
| Mailing Telephone | 8053618028 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2019-04-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
AMD-276 | HI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | H3451 | 05 |
| Street Address |
80 B VETERANS BLVD I-40, EXIT 102 |
| City | ACOMA |
| State | NM |
| Zip Code | 87034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619970779 | James H Urbina | Internal Medicine | 80 B Veterans Blvd, I-40, Exit 102, Acoma, NM 87034 | 2005-05-23 |
| 1528604303 | Lisa Spero | Nurse Practitioner | 80 B Veterans Blvd, Acoma, NM 87034 | 2019-11-27 |
| 1689029860 | Muna S Sheikh | Internal Medicine | 80 B Veterans Blvd, Acoma, NM 87034 | 2016-04-26 |
| 1639523855 | Roberto Carlos Montes | Psychologist | 80 B Veterans Blvd, Acoma, NM 87034 | 2016-04-14 |
| 1972961068 | Aline Bayard | Nurse Practitioner | 80 B Veterans Blvd, Acoma, NM 87034 | 2016-02-03 |
| 1093188724 | Janet E Dominguez | Nurse Practitioner | 80 B Veterans Blvd, Acoma, NM 87034 | 2015-11-03 |
| 1124491949 | Patricia A Monroe | Nurse Practitioner | 80 B Veterans Blvd, Acoma, NM 87034 | 2015-11-02 |
| 1033594122 | Hlengiwe Lindani Sibanda | Nurse Practitioner | 80 B Veterans Blvd, Acoma, NM 87034-0536 | 2015-07-30 |
| 1851774392 | Caleb Vanderveen | Family Medicine | 80 B Veterans Blvd, Acoma, NM 87034 | 2015-07-01 |
| 1669721122 | Shawn P Giorgianni | Emergency Medical Technician, Paramedic | 80 B Veterans Blvd, Acl-ihs, Acoma, NM 87034 | 2012-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114535192 | Troy Stephen Weeldreyer | Social Worker | 45 Pinsbaari Dr, Acoma, NM 87034 | 2020-07-16 |
| 1306486857 | Mallery Chino | Case Manager/Care Coordinator | 47 Pinsbarri Drive, Acoma, NM 87034 | 2020-01-13 |
| 1700340841 | Thomas Simon Vallo | Case Manager/Care Coordinator | 45 Pinbaari Drive, Acoma, NM 87034 | 2019-01-23 |
| 1649777053 | Amanda Jean Garcia | Counselor | 99b Sunrise Rd, Pueblo of Acoma, NM 87034 | 2018-04-11 |
| 1356850754 | Korey B Still | Dentist | 80 B Veterans Blvd., Acoma, NM 87034 | 2017-09-28 |
| 1508395278 | Shelby Bobelu | Social Worker | 45 Pinsbarri Dr., Acoma, NM 87034 | 2017-06-07 |
| 1558817270 | Amanda Lucario | Technician, Other | 1253 Haaku Road, Acoma, NM 87034 | 2016-09-01 |
| 1073961355 | Rhayna Dannielle Walizer | Social Worker | 45 Pinsbarri Dr, Acoma, NM 87034 | 2016-05-27 |
| 1417305715 | Everett Chavez | Counselor | 45 Pinsbaari, Acoma, NM 87034 | 2016-05-26 |
| 1952758047 | Lonnie Lewis | Counselor | 33 Pinsbaari Drive, Acoma, NM 87034 | 2016-05-18 |
| Find all providers in zip 87034 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992981609 | Brenda Y Pacheco | Physician Assistant | 80 B Veterans Blvd, Acoma, NM 87034 | 2008-01-11 |
| 1770699407 | David L Miller | Physician Assistant | 80 B Veterans Blvd, Acoma, NM 87034 | 2006-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386284602 | Christopher Whorley | Physician Assistant | 4683 Idlewilde Ln Se, Albuquerque, NM 87108-3421 | 2020-01-15 |
| 1053836809 | Alysha Gallegos | Physician Assistant | 6112 Molinero Ct Sw, Albuquerque, NM 87105-6814 | 2017-08-13 |
| 1164978540 | Deborah L Thorne | Physician Assistant | 111 W Lucero Ave Ste 6, Las Cruces, NM 88005-1829 | 2016-08-26 |
| 1134572738 | Weston Bradley Graff | Physician Assistant | 703 Christopher Dr, Belen, NM 87002-2617 | 2016-07-19 |
| 1295194629 | Ryan Grange | Physician Assistant | 1851 Old Highway 66 Unit 1, Edgewood, NM 87015 | 2016-02-12 |
| 1720445562 | Rebecca Gahan Brown | Physician Assistant | 150 N Roadrunner Pkwy, Las Cruces, NM 88011 | 2016-01-25 |
| 1508232240 | Edward R Watson | Physician Assistant | 2530 S Telshor Blvd Ste 207, Las Cruces, NM 88011-4975 | 2015-08-17 |
| 1306225180 | Allison Rose Crossey | Physician Assistant | 201 Cedar Street Se, Suite 6600, Albuquerque, NM 87106 | 2015-05-26 |
| 1528452208 | Taylor Bottari | Physician Assistant | 208 W Dl Ingram, Cannon Afb, NM 88103 | 2015-03-20 |
| 1336543115 | Pamela O Black Md, P.a., Dba Quadra Health Institute | Physician Assistant | 3820 Commons Ave Ne # M, Albuquerque, NM 87109-5831 | 2014-10-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.