Individual
TRACY L MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
320 E NORTH AVE, PITTSBURGH, PA 15212-4756
(412) 359-3155
(412) 359-3483
Mailing address
4135 BOARDMAN CANFIELD RD, SUITE 101, CANFIELD, OH 44406-9803
(330) 286-5330
(330) 286-5396
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
RN-268393
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
RN530907
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000357295
ANTHEM
OH
05
—
2290462
—
OH
05
—
2603084000
—
WV
01
—
8233342
MEDICARE PTAN
OH
Enumeration date
09/25/2006
Last updated
10/21/2024
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