Individual
MRS. ELISA SPADARO MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1 JEFFERSON BARRACKS DR, SAINT LOUIS, MO 63125-4181
(314) 599-3803
Mailing address
1 JEFFERSON BARRACKS DR, SAINT LOUIS, MO 63125-4181
(314) 599-3803
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
2007007648
MO
363L00000X
Nurse Practitioner
Primary
2011040127
MO
363LF0000X
Family Nurse Practitioner
2011040127
MO
Other
Enumeration date
11/16/2011
Last updated
11/21/2025
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