Provider Demographics
NPI:1902480999
Name:MORA, ARNA KETURAH (MD)
Entity Type:Individual
Prefix:
First Name:ARNA
Middle Name:KETURAH
Last Name:MORA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 12TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:EAST GRAND FORKS
Mailing Address - State:MN
Mailing Address - Zip Code:56721-3229
Mailing Address - Country:US
Mailing Address - Phone:605-431-4776
Mailing Address - Fax:
Practice Address - Street 1:1115 E 20TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1013
Practice Address - Country:US
Practice Address - Phone:605-575-1644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program