KELLY MOORE (NPI# 1669072112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669072112 |
| Entity Type | Individual |
| Full Name | KELLY MOORE |
| Credential | NP |
| Practice Address |
1401 W Pulaski St Fort Worth TX 76104-2717 |
| Mailing Address |
4840 Cliburn Dr Fort Worth TX 76244-6128 |
| Practice Telephone | 8174548055 |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2020-10-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
1011153 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457901233 | Kelly Lynn Moore | Counselor | 11111 E Mississippi Ave Ste 268, Aurora, CO 80012-3106 | 2019-09-13 |
| 1962981563 | Kelly Moore | Massage Therapist | 1776 S Jackson St Ste 830, Denver, CO 80210-3807 | 2018-08-14 |
| 1134619018 | Kelly Michelle Moore | Social Worker | 446 Pinecrest Cir, Long Beach, MS 39560-3639 | 2018-05-16 |
| 1932630902 | Kelly Moore | Optometrist | 1611 Plummer St #112e, North Hills, CA 91403-2036 | 2017-03-22 |
| 1780128942 | Kelly Renee Moore | Nurse Practitioner | 224 Margaret Michelle Ct, Saint Peters, MO 63376-4812 | 2016-12-07 |
| 1568817369 | Kelly Moore | Skilled Nursing Facility | 29 Nonotuck Rd, West Springfield, MA 01089-1616 | 2016-04-28 |
| 1588042980 | Kelly Moore | Registered Nurse | 1507 Broad Blvd, Cuyahoga Falls, OH 44223-2434 | 2015-05-18 |
| 1770977563 | Kelly Moore | Registered Nurse | 1120 Huffman Rd Ste 24-787, Anchorage, AK 99515-3516 | 2015-03-19 |
| 1790106342 | Kelly Ann Moore | Behavioral Analyst | 17845 Ridgeland Ave, Tinley Park, IL 60477-4383 | 2013-12-29 |
| 1720327570 | Kelly Moore | Occupational Therapy Assistant | 1848 E Gemini Dr, Tempe, AZ 85283-6000 | 2013-02-13 |
| Street Address |
1401 W PULASKI ST |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-2717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689668857 | Cathleen M Delaney | Nurse Practitioner | 1401 W Pulaski St, Fort Worth, TX 76104-2717 | 2005-09-02 |
| 1356941066 | Ashley Dyok | Nurse Practitioner | 1401 W Pulaski St, Fort Worth, TX 76104-2717 | 2020-10-30 |
| 1316561012 | Kylie R Cherry | Nurse Practitioner | 1401 W Pulaski St, Fort Worth, TX 76104-2717 | 2020-05-29 |
| 1295371037 | Katelyn M Okaro | Nurse Practitioner | 1401 W Pulaski St, Fort Worth, TX 76104-2717 | 2019-11-26 |
| 1174166573 | Caroline W Sims | Nurse Practitioner | 1401 W Pulaski St, Fort Worth, TX 76104-2717 | 2019-10-18 |
| 1487121752 | Ashley A Hickman | Nurse Practitioner | 1401 W Pulaski St, Fort Worth, TX 76104-2717 | 2018-10-25 |
| 1538669916 | Cook Children's Medical Center | Pediatrics | 1401 W Pulaski St, Fort Worth, TX 76104-2717 | 2018-02-13 |
| 1093215477 | Cook Children's Medical Center | Clinic/Center | 1401 W Pulaski St, Fort Worth, TX 76104-2717 | 2018-02-13 |
| 1437692464 | Emiliee Robinson | Nurse Practitioner | 1401 W Pulaski St, Fort Worth, TX 76104-2717 | 2016-11-22 |
| 1952843781 | Valerie Kimbrough | Physician Assistant | 1401 W Pulaski St, Fort Worth, TX 76104-2717 | 2016-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770182636 | Jenna Donlon | Nurse Practitioner | 3201 Western Center Blvd Ste 125, Fort Worth, TX 76137-7135 | 2020-10-21 |
| 1023594009 | Erica M Lucas | Nurse Practitioner | 800 8th Ave Ste 200, Fort Worth, TX 76104-2619 | 2018-07-13 |
| 1003280686 | Susan Akberzie | Nurse Practitioner | 3400 Texas Sage Trl Ste 148, Fort Worth, TX 76177 | 2015-11-19 |
| 1427489400 | Brenda Bosch | Nurse Practitioner | 11807 Med Park Dr, Ste 365, Fort Worth, TX 76028-3509 | 2013-12-02 |
| 1447535463 | Anamarina Jarecke | Nurse Practitioner | 5300 Buchanan St, Fort Worth, TX 76114-1304 | 2011-10-21 |
| 1770873077 | Michelle Beatrice Oconnor | Nurse Practitioner | 6239 Granbury Rd, Fort Worth, TX 76133-3401 | 2011-04-08 |
| 1912208687 | Andrea Madeliene Newman | Nurse Practitioner | 901 7th Ave Ste 120, Fort Worth, TX 76104-2724 | 2010-11-10 |
| 1629306709 | Autumn Brianne Morris | Nurse Practitioner | 901 W Rosedale St, Fort Worth, TX 76104-4672 | 2009-11-30 |
| 1235466624 | Courtney Shea Stewart | Nurse Practitioner | 5917 Yosemite Dr, Fort Worth, TX 76112-3938 | 2009-11-06 |
| 1548412018 | Christie Ramirez | Nurse Practitioner | 8376 Mojave Trl, Fort Worth, TX 76116-3638 | 2008-10-16 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
Please comment or provide details below to improve the information on KELLY MOORE.
| 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.