Individual
TREVENA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2000 OLATHE, KANSAS CITY, KS 66160-1003
(913) 588-5746
(913) 274-3546
Mailing address
2000 OLATHE BLVD, ATTN: CREDENTIALING OFFICE, KANSAS CITY, KS 66160
(913) 588-5746
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2003012943
MO
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
04-40273
KS
Other
Enumeration date
05/31/2006
Last updated
06/13/2019
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