Individual
SHAWNA D MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
518 PINE ST, STEELVILLE, MO 65565-6041
(573) 775-5838
(573) 729-4035
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2002005693
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730374349
—
MO
01
—
431560263
TRICARE
MO
Enumeration date
09/07/2007
Last updated
03/28/2014
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