Individual
BROOK MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
328 N MARK ALLEN ST, WICHITA, KS 67212-5455
(316) 992-3540
Mailing address
328 N MARK ALLEN ST, WICHITA, KS 67212-5455
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
53-79375-092
KS
Other
Enumeration date
03/27/2020
Last updated
03/27/2020
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