# ANNETTE RENE MOORE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1033141155
- **Gender:** F
- **Credential:** C.N.P.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | 71000750A | IN | Yes |

## Other

- **Enumeration date:** 07/07/2006
- **Last updated:** 11/27/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000042207 | ANTHEM BCBS | IN |
| 05 | — | 100473980 | — | IN |
| 01 | — | 1161025 | PASSPORT KY MEDICAID | KY |
| 01 | — | 2439492000 | PASSPORT ADVANTAGE | KY |
| 01 | — | 500012166 | MEDICARE RAILROAD | — |
| 01 | — | 5012042 | AETNA | — |
| 01 | — | 709911P | SIHO | IN |
| 05 | — | 78007887 | — | KY |