Individual
LAURA B MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-8500
Mailing address
24701 EUCLID AVE, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
NP01131
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
NP01131
OH
364SX0200X
Oncology Clinical Nurse Specialist
NP-01131
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224410
UNISON
OH
01
—
000000539708
ANTHEM
OH
05
—
2542887
—
OH
01
—
363856
WELLCARE
OH
01
—
7313676
AETNA
OH
01
—
751172
BUCKEYE
OH
01
—
P00207705
RAILROAD MEDICARE
OH
01
—
P00449247
RAILROAD MEDICARE
OH
Enumeration date
07/20/2006
Last updated
09/19/2011
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