Individual
MRS. DANYA M MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
922 TRIPLETT ST, OWENSBORO, KY 42303-3118
(270) 685-5077
Mailing address
922 TRIPLETT STREET, OWENSBORO, KY 42303-3222
(270) 685-5077
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
KY
363AM0700X
Medical Physician Assistant
PA1063
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000536383
ANTHEM
—
01
—
000000668071
COOP HEALTH ANTHEM #
KY
Enumeration date
09/21/2007
Last updated
10/04/2016
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