Individual
HEATHER MICHELLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
4050
SC
363LP0200X
Pediatric Nurse Practitioner
R 145595-5
MN
363LP0200X
Pediatric Nurse Practitioner
Primary
SXP-10038
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60602376
—
CO
05
—
NP1559
—
SC
Enumeration date
10/08/2008
Last updated
07/12/2013
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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