Individual
MRS. JAMIE LEIGH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
603 E GAINES DR., CLINTON, MO 64735
(660) 890-8715
(660) 890-8485
Mailing address
603 E GAINES DR., CLINTON, MO 64735
(660) 890-8715
(660) 890-8485
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
2018038102
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420065964
—
MO
Enumeration date
10/24/2018
Last updated
05/21/2024
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