Individual
JOHN A. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1171 W TARGET RANGE RD, NOGALES, AZ 85621-2415
(520) 287-4747
Mailing address
3501 E SPEEDWAY BLVD, TUCSON, AZ 85716-3917
(520) 833-5171
(888) 395-3034
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA1063
AZ
367500000X
Certified Registered Nurse Anesthetist
R53384
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02373882
—
NM
01
—
P00347089
RR MEDICARE
—
Enumeration date
03/24/2006
Last updated
09/03/2025
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