Individual
JENNIFER RENAE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 AVALON ST, BORGER, TX 79007-8303
(806) 886-0177
Mailing address
120 AVALON ST, BORGER, TX 79007-8303
(806) 886-0177
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP1186147
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1186147
TX
Other
Enumeration date
04/14/2025
Last updated
08/05/2025
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