Individual
REBECCA LYNN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
905 W GOVERNOR RD, SUITE 250, HERSHEY, PA 17033-2310
(717) 531-7235
Mailing address
PO BOX 858, MCA410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP010716
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031501200001
—
PA
Enumeration date
05/19/2010
Last updated
11/24/2017
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