Individual
THOMAS EARL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, FNP-BC
Contact information
Practice address
6276 COUNTY ROAD 107, PROCTORVILLE, OH 45669-8867
(740) 451-4000
Mailing address
5575 DANA DR, ASHLAND, KY 41102-9647
(606) 547-9042
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.0027665
OH
363LF0000X
Family Nurse Practitioner
108958
WV
363LF0000X
Family Nurse Practitioner
3014405
KY
Other
Enumeration date
02/26/2020
Last updated
12/16/2024
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