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JONATHAN KURTIS MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
4315 DIPLOMACY DR, ANCHORAGE, AK 99508-5926
(907) 563-2662
Mailing address
2111 W STERLING RD, BURBANK, OH 44214-9562
(330) 749-9474

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
197941
AK
163W00000X
Registered Nurse
439888
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
199497
AK

Other

Enumeration date
09/23/2022
Last updated
10/11/2022
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