Individual
KIMBERLY LEIGH MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN CPNP-AC CPNP
Contact information
Practice address
1935 MOTOR ST, DALLAS, TX 75235-7701
(214) 456-2033
Mailing address
3717 COLE AVE, APARTMENT 274, DALLAS, TX 75204-4502
(919) 225-4953
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP114683
TX
363LP0222X
Critical Care Pediatric Nurse Practitioner
728846
TX
Other
Enumeration date
11/08/2006
Last updated
04/23/2024
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