Moore, Tina

Moore, Tina is an individual health care provider with primary practice located at 1860 N Church Rd , Liberty MO 64068. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Moore, Tina can be contacted via phone (816) 415-2828.

Contact Information

Primary practice address
1860 N Church Rd Liberty MO 64068
Phone: (816) 415-2828
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2014000703 Missouri

Profile Details

NPI number 1033531181
LBN Legal business name Moore, Tina
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2014
Last updated Nov 1st, 2019 - about 7 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 1033531181 NPPES
Missouri Other 2014000703 LICENSE
Missouri MEDICAID 1033531181 LICENSE

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