Moore, Brody

Moore, Brody is an individual health care provider with primary practice located at 3400 N Woods Ln , Rogers AR 72756-6712. He recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as his primary health care specialty. Moore, Brody can be contacted via phone (479) 636-3190.

Contact Information

Primary practice address
3400 N Woods Ln Rogers AR 72756-6712
Phone: (479) 636-3190
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X L055574 Arkansas

Profile Details

NPI number 1487352654
LBN Legal business name Moore, Brody
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2023
Last updated Feb 17th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487352654 NPPES
Arkansas MEDICAID 251C00000X

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