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Individual
MRS. CORINNE LENORE MOORE
Active
Individual
MRS. CORINNE LENORE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
1096
KY
363A00000X
Physician Assistant
Primary
PA1096
KY
363AM0700X
Medical Physician Assistant
1096
KY
363AM0700X
Medical Physician Assistant
PA1096
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100056830
—
KY
01
—
P00920661
RRMC
—
Enumeration date
04/23/2008
Last updated
08/07/2013
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