Individual
JANICE MARIE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
9205 STANTON L YOUNG BLVD, WP2430, OKLAHOMA CITY, OK 73104-3251
(405) 271-7449
Mailing address
PO BOX 996, EDMOND, OK 73083-0996
(405) 226-0163
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2013042559
MO
363L00000X
Nurse Practitioner
536444
TX
363L00000X
Nurse Practitioner
AP125297
TX
363L00000X
Nurse Practitioner
Primary
N3097006
OK
363L00000X
Nurse Practitioner
R0053173
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100180710A
—
OK
Enumeration date
10/14/2005
Last updated
05/25/2016
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