Individual
MS. LISA JO MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3033 S KANSAS EXPY, SPRINGFIELD, MO 65807-5969
(417) 881-7442
(417) 988-9844
Mailing address
861 S DRY GULCH RD, NIXA, MO 65714-6708
(417) 234-1026
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2020011705
MO
363LF0000X
Family Nurse Practitioner
2020011705
MO
Other
Enumeration date
10/22/2020
Last updated
12/17/2020
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