Individual
MICHAEL ALAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
2245 WINCHESTER AVE, ASHLAND, KY 41101-7848
(606) 408-2600
(606) 408-2605
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-6200
(606) 408-6612
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
024237
OH
363LF0000X
Family Nurse Practitioner
Primary
3010940
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100465060
—
KY
Enumeration date
01/12/2017
Last updated
02/19/2019
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