Individual
CARLY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
2831 FORT MISSOULA RD STE 146, MISSOULA, MT 59804-7401
(406) 327-3850
(406) 327-3851
Mailing address
2831 FORT MISSOULA RD STE 146, MISSOULA, MT 59804-7401
(406) 327-3850
(406) 327-3851
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NUR-APRN-LIC-195589
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NUR-APRN-LIC-195589
MONTANA APRN LICENSE
MT
Enumeration date
06/16/2022
Last updated
04/01/2024
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