Individual
DIANE OLLIVE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
8033 DIXIE HWY, LOUISVILLE, KY 40258
(502) 937-3155
(502) 935-0743
Mailing address
PO BOX 856300, DEPT 125, LOUISVILLE, KY 40285-6300
(502) 937-3155
(502) 935-0743
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6250P
KY
363LF0000X
Family Nurse Practitioner
6250P
KY
Other
Enumeration date
12/04/2009
Last updated
05/29/2018
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