Individual
JEANNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2200 TACKETTS MILL DR, WOODBRIDGE, WOODBRIDGE, VA 22192-3012
(703) 494-4961
Mailing address
2200 TACKETTS MILL DR, WOODBRIDGE, WOODBRIDGE, VA 22192-3012
(703) 494-4961
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R 152237-0
MN
363LF0000X
Family Nurse Practitioner
Primary
0024168326
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-07324
MEDICA
—
01
—
062J3CA
BLUE CROSS BLUE SHIELD
MN
01
—
141044
UCARE MINNESOTA
MN
01
—
1651881
AMERICA'S PPO
—
01
—
23218
SIOUX VALLEY HEALTH PLAN
—
01
—
500020824
PALMETTO GBA RAILROAD MCR
—
05
—
984639500
—
MN
01
—
NA2081029811
PREFERRED ONE
—
Enumeration date
09/29/2005
Last updated
09/16/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us