# CHRISTINE L MOORE DO PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861449621
- **Authorized official:** MR. JAY COLLINS (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (816) 322-0701

## Contact information

- **Practice address:** 6325 BLUE RIDGE BLVD, SUITE C, RAYTOWN, MO 64133-4886
- **Practice address phone:** (816) 322-0701
- **Practice address fax:** (816) 322-2035
- **Mailing address:** 6325 BLUE RIDGE BLVD, SUITE C, RAYTOWN, MO 64133-4886
- **Mailing address phone:** (816) 322-0701
- **Mailing address fax:** (816) 322-2035

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 05/27/2006
- **Last updated:** 10/26/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 25009021 | BCBS OF KC | MO |