Individual
GERRI L MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
340 STARLITE DR, HENDERSON, KY 42420-6102
(270) 844-8515
(270) 844-8183
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
3005741
KY
363L00000X
Nurse Practitioner
Primary
3005741
KY
363L00000X
Nurse Practitioner
71006183A
IN
363LF0000X
Family Nurse Practitioner
3005741
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100075040
—
KY
Enumeration date
03/03/2009
Last updated
10/28/2020
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