Individual
DAVID B MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4801 COLLEGE BLVD., LEAWOOD, KS 66211-1628
(913) 491-3999
(913) 491-9309
Mailing address
4801 COLLEGE BLVD., LEAWOOD, KS 66211-1628
(913) 491-3999
(913) 491-9309
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
14-107432-091
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
43-556867-091
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200606900B
—
KS
Enumeration date
05/13/2009
Last updated
11/16/2010
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