Individual
DANIELLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3409 UNION BLVD, SAINT LOUIS, MO 63115-1127
(314) 261-4834
(314) 383-3970
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(314) 261-4834
(314) 383-3970
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2017002567
MO
363LG0600X
Gerontology Nurse Practitioner
2011031354
MO
Other
Enumeration date
08/30/2017
Last updated
07/21/2022
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