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Individual

KIMBERLY WELLS MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1030 KENTONTOWN RD, MOUNT OLIVET, KY 41064-7649
(606) 724-5020
Mailing address
PO BOX 341, MOUNT OLIVET, KY 41064-0341
(606) 842-0258

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1099445
TX
363LF0000X
Family Nurse Practitioner
Primary
26NJ01212500
NJ
363LF0000X
Family Nurse Practitioner
3014345
KY

Other

Enumeration date
11/02/2020
Last updated
11/18/2024
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