# MRS. CORINNE LENORE MOORE

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

## Provider details

- **NPI number:** 1225203128
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 1096 | KY | — |
| 363A00000X | Physician Assistant | PA1096 | KY | Yes |
| 363AM0700X | Medical Physician Assistant | 1096 | KY | — |
| 363AM0700X | Medical Physician Assistant | PA1096 | KY | — |

## Other

- **Enumeration date:** 04/23/2008
- **Last updated:** 08/07/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100056830 | — | KY |
| 01 | — | P00920661 | RRMC | — |