Moore, Denise R

Moore, Denise R is an individual health care provider with primary practice located at 3850 S National Ave 520, Springfield MO 65807-5287. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Moore, Denise R can be contacted via phone (417) 875-2607.

Contact Information

Primary practice address
3850 S National Ave 520 Springfield MO 65807-5287
Phone: (417) 875-2607
Fax: (417) 875-2674
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 089074 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 2010017028 Missouri

Profile Details

NPI number 1790098580
LBN Legal business name Moore, Denise R
Credentials ACNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2010
Last updated Dec 27th, 2018 - about 8 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 1790098580 NPPES
Missouri MEDICAID 420017088
Missouri MEDICAID 1790098580

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