Individual
AMANDA D MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
113 WALNUT ST, IDALOU, TX 79329-4003
(806) 892-2537
(806) 892-2726
Mailing address
3601 4TH ST, LUBBOCK, TX 79430-8312
(806) 743-2373
(806) 743-2399
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP119568
TX
363LF0000X
Family Nurse Practitioner
709372
TX
Other
Enumeration date
10/21/2010
Last updated
12/02/2021
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