Individual
KENNAN ASHTON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
7301 ROGERS AVE STE 4, FORT SMITH, AR 72903-4100
(479) 931-4490
Mailing address
5224 75TH ST STE D, LUBBOCK, TX 79424-2525
(806) 712-1096
(806) 771-2093
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A005133
AR
Other
Enumeration date
06/11/2017
Last updated
03/16/2026
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