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Individual

KENQUISHA MARIE MOORMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
2950 W MARKET ST, LOUISVILLE, KY 40212-1860
(502) 801-9502
(877) 284-3296
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
(502) 801-9502
(877) 284-3296

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3012039
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100529550
KY
01
K246490
MEDICARE
KY
Enumeration date
05/02/2018
Last updated
02/11/2026
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