Individual
MS. VICKI HURLEY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
500 S MOUNT OLIVE ST, SUITE 200, SILOAM SPRINGS, AR 72761-3602
(479) 524-9550
(479) 524-9552
Mailing address
614 E EMMA AVE, SUITE 300, SPRINGDALE, AR 72764-4634
(479) 751-7417
(479) 751-4898
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AO1821
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5-Y752
BLUE CROSS BLUE SHIELD
AR
Enumeration date
10/02/2006
Last updated
11/08/2011
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