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Individual
SHANNEN MOORE
Active
Individual
SHANNEN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
701502
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
383018
NY
367500000X
Certified Registered Nurse Anesthetist
701502
NY
Other
Enumeration date
05/11/2015
Last updated
01/27/2026
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