Individual
MR. NATHAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-C
Contact information
Practice address
7334 S LINDBERGH BLVD, SAINT LOUIS, MO 63125-4522
(314) 892-8352
Mailing address
7334 S LINDBERGH BLVD, SAINT LOUIS, MO 63125-4522
(314) 892-8352
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2021013225
MO
363LP2300X
Primary Care Nurse Practitioner
ARNP9367810
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105038800
—
FL
Enumeration date
08/08/2017
Last updated
05/27/2021
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