Individual
MRS. DENISE R MOORE
Active
Individual
MRS. DENISE R MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
089074
MO
363LA2100X
Acute Care Nurse Practitioner
Primary
2010017028
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790098580
—
MO
05
—
420017088
—
MO
Enumeration date
07/21/2010
Last updated
12/27/2018
Update your record
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