Individual
REBECCA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, DNP
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-0124
(859) 344-5552
Mailing address
PO BOX 636324, CINCINNATI, OH 45263-6324
(859) 301-0124
(859) 301-0699
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3015990
KY
363LA2100X
Acute Care Nurse Practitioner
LE-00033347
OH
Other
Enumeration date
07/27/2020
Last updated
03/11/2025
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