Individual
AMBER MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1165 E CHERRY ST, TROY, MO 63379-1520
(636) 528-1919
Mailing address
1165 E CHERRY ST, TROY, MO 63379-1520
(636) 525-1919
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2017002502
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420060667
—
MO
Enumeration date
02/28/2017
Last updated
03/11/2019
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