Individual
HEATHER MICHELLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
13123 E 16TH AVE, AURORA, CO 80045-7106
(720) 777-1234
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
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
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