Organization
CHARIS HEALTHCARE OF MISSOURI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY LYNN MOORE ARPN (OWNER)
(870) 489-8633
Entity
Organization
Contact information
Practice address
1815 KATELYN ST, KENNETT, MO 63857-4112
(870) 489-8633
Mailing address
1815 KATELYN ST, KENNETT, MO 63857-4112
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/20/2025
Last updated
10/20/2025
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