MRS. LISA MARCELLA MOORE (NPI# 1336643410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336643410 |
| Entity Type | Individual |
| Full Name | MRS. LISA MARCELLA MOORE |
| Other Name | MS. LISA MARCELLA BREYMIER |
| Credential | CNP |
| Practice Address |
500 W. Votaw Street Portland IN 47371 |
| Practice Telephone | 2707264350 |
| Mailing Telephone | 2707264350 |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2019-11-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71008271A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN.CNP.022576 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 613 Beatrice Drive, Union City, OH 45390 | 9374670180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718903 | Lisa Jo Moore | Nurse Practitioner | 2623 S Main Street, Nixa, MO 64804 | 2020-10-22 |
| 1114525813 | Lisa Michelle Moore | Homemaker | 2541 Rockcastle Ct, Miamisburg, OH 45342-7259 | 2020-10-14 |
| 1851913693 | Lisa Moore | Home Health Aide | 2208 Perry Ave, Edgewood, MD 21040-2806 | 2020-05-14 |
| 1275099954 | Lisa Moore | Nurse Practitioner | 6 Misty Glen Ct, Irmo, SC 29063-8134 | 2019-02-18 |
| 1831628494 | Lisa Moore | Counselor | 2714 Tupelo St, Lake Charles, LA 70601-7376 | 2017-06-07 |
| 1801348818 | Lisa Moore | Specialist | 2147 Skyview Dr, Fayetteville, NC 28304-5126 | 2016-10-26 |
| 1679955801 | Lisa Moore | Nurse Anesthetist, Certified Registered | 1481 Meads, Orange, CA 92869 | 2015-06-24 |
| 1689068751 | Lisa Moore | Registered Nurse | 748 Addington Dr, Winterville, NC 28590-7102 | 2015-03-26 |
| 1700292190 | Lisa Moore | Nurse's Aide | 2765 Bramblebush Ct, Columbus, OH 43224-2505 | 2014-07-07 |
| 1114357068 | Lisa Moore | Case Manager/Care Coordinator | Route 1 Box 35d, Boley, OK 74829 | 2013-11-13 |
| Street Address |
500 W. VOTAW STREET |
| City | PORTLAND |
| State | IN |
| Zip Code | 47371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093365355 | Susan Hathaway | Technician | 3783 West 800 South, Portland, IN 47371 | 2019-09-18 |
| 1609186030 | Carolyn Louise Keihn | Nurse Practitioner | 430 W. Votaw St., Portland, IN 47371 | 2010-10-19 |
| 1922125384 | Carla Ann Ford | Social Worker | 1758 W 100s, Jay County Hopsital Behavioral Health, Portland, IN 47371 | 2007-03-23 |
| 1902824956 | Midwest Healthstrategies, Inc | Physical Therapist | 1745 W 100 S, Portland, IN 47371 | 2006-07-18 |
| 1346212875 | Jenni Clear | Chiropractor | 603 N Meridian St, Portland, IN 47371 | 2006-02-07 |
| 1497756043 | Jay County Government | Ambulance | 902 N Creagor Ave, Portland, IN 47371 | 2005-08-04 |
| 1336694736 | Anne Hardesty | Nurse Practitioner | 500 W Votaw St, Portland, IN 47371 | 2016-08-16 |
| 1861574006 | Wal-mart Stores East, Lp | Technician/Technologist | 950 W Votaw St, Portland, IN 47371 | 2006-10-19 |
| 1144296088 | Kent Farnsworth | Emergency Medicine | 500 W Votaw St, Portland, IN 47371 | 2006-02-28 |
| 1982677241 | James P Clear | Chiropractor | 603 N Meridian St, Portland, IN 47371 | 2006-02-08 |
| Find all providers in zip 47371 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822794 | Danielle Langer | Nurse Practitioner | 35 Ridgeview Rd, Portland, CT 06480-4014 | 2020-08-23 |
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1114566650 | Sadie Garnache-poirier | Nurse Practitioner | 65 W Commercial St Ste 107, Portland, ME 04101-4789 | 2020-01-02 |
| 1902441629 | Jennifer Marie Colpitts | Nurse Practitioner | 1600 Congress St Ste B, Portland, ME 04102-2148 | 2019-11-18 |
| 1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
| 1265081640 | Christina Lee | Nurse Practitioner | 144 State St # 1, Portland, ME 04101-3776 | 2019-09-09 |
| 1407401474 | Abby Christine Vopal | Nurse Practitioner | 66 Bramhall St Fl 1, Portland, ME 04102-3355 | 2019-08-07 |
| 1770145294 | Cynthia Marie Martinez | Nurse Practitioner | 1145 Austin St, Portland, TX 78374-2013 | 2019-07-04 |
| 1528532306 | Matthew James Keelin | Nurse Practitioner | 6801 Ne Cornfoot Rd, Portland, OR 97218-2743 | 2019-01-15 |
| 1659847580 | Colleen Jeanette Scott | Nurse Practitioner | 650 Nw Irving St, Portland, OR 97209-1272 | 2018-10-18 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.