SANDRA LEE MOORE (NPI# 1710504931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710504931 |
| Entity Type | Individual |
| Full Name | SANDRA LEE MOORE |
| Credential | AGACNP, APRN |
| Practice Address |
609 W Maple Ave Springdale AR 72764-5335 |
| Mailing Address |
8140 Ozark Ridge Dr Rogers AR 72756-6325 |
| Practice Telephone | 4797571260 |
| Mailing Telephone | 4793875225 |
| Enumeration Date | 2020-07-03 |
| Last Update Date | 2020-10-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
124033 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629532569 | Sandra Ann Moore | Substance Abuse Rehabilitation Facility | 2632 E 17th St, Bremerton, WA 98310-5058 | 2019-01-24 |
| 1942701826 | Sandra Moore | Licensed Practical Nurse | 48 Huntley Rd, Elmont, NY 11003-1407 | 2018-02-26 |
| 1083038350 | Sandra Moore | Occupational Therapist | Psc 76 Box 263, 65th Med Group/sgh, Apo, AE 09720-0003 | 2014-02-07 |
| 1376843714 | Sandra Jeanne Moore | Registered Nurse | 107 W Broadway, Pathway's Behavioral Health Care, Eldorado Springs, MO 64744 | 2010-11-02 |
| 1073767232 | Sandra Smith Moore | Physical Therapist | 3915 Puckett Creek Xing, E823, Murfreesboro, TN 37128-4260 | 2008-11-13 |
| 1790906741 | Sandra C Moore | Pharmacist | 160 N Post Rd, West Windsor, NJ 08550-5003 | 2007-05-01 |
| 1023135886 | Sandra Moore | Licensed Practical Nurse | 130 Preserve Dr, Royal Palm Beach, FL 33411-1569 | 2007-03-24 |
| 1881725802 | Sandra Evette Moore | Social Worker | 2506 Lesh Ct, Crofton, MD 21114-3221 | 2007-03-08 |
| 1396804167 | Sandra Moore | Nurse Practitioner | Of State 2401 E St Nw, M Med Qi, Sa 1, Washington, DC 20522-0001 | 2006-12-08 |
| 1285725523 | Sandra J Moore | Chiropractor | 1971 Holton Rd, Suite B, North Muskegon, MI 49445-1698 | 2006-09-28 |
| Street Address |
609 W MAPLE AVE |
| City | SPRINGDALE |
| State | AR |
| Zip Code | 72764-5335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689676272 | Regency Hospital of Northwest Arkansas, LLC | Long Term Care Hospital | 609 W Maple Ave, 6th Floor, Springdale, AR 72764-5335 | 2005-08-12 |
| 1356957799 | Victoria Ashley Sollestre | Physician Assistant | 609 W Maple Ave, Springdale, AR 72764-5335 | 2020-09-21 |
| 1588279475 | Ashley Early | Nurse Practitioner | 609 W Maple Ave, Springdale, AR 72764-5394 | 2020-09-09 |
| 1386291656 | Dominique Ann Ertolacci | Nurse Practitioner | 609 W Maple Ave, Springdale, AR 72764-5335 | 2019-08-21 |
| 1861055204 | Dustin J Franklin | Nurse Anesthetist, Certified Registered | 609 W Maple Ave, Springdale, AR 72764-5335 | 2019-04-22 |
| 1407419278 | Samuel Tanner Burks | Registered Nurse | 609 W Maple Ave, Springdale, AR 72764-5335 | 2019-04-17 |
| 1285199133 | Shelby Lane Harrison | Registered Nurse | 609 W Maple Ave, Springdale, AR 72764-5335 | 2019-02-05 |
| 1750865929 | Teqienna Dianne Randall | Nurse Practitioner | 609 W Maple Ave, Springdale, AR 72764-5335 | 2018-09-24 |
| 1588144182 | David R Massey Md Pllc | Psychiatry & Neurology | 609 W Maple Ave, Springdale, AR 72764-5335 | 2018-08-14 |
| 1619453495 | Jacquelyn Lange-halley Md Pllc | Psychiatry & Neurology | 609 W Maple Ave, Springdale, AR 72764 | 2018-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851903884 | Conway County Community Service Inc. | Community/Behavioral Health | 616 E. Emma Avenue, Suite 244, Springdale, AR 72764 | 2020-08-20 |
| 1316592801 | Above and Beyond Pediatric Therapy, Inc | Speech-Language Pathologist | 2700 American St., Ste B, Springdale, AR 72764 | 2019-08-02 |
| 1053871061 | Specialized Hearing Instruments, Inc. | Audiologist-Hearing Aid Fitter | 958 S. West End St., Springdale, AR 72764 | 2019-03-25 |
| 1801385976 | Taylor Beauregard Kelamis | Nurse Practitioner | Mercy Clinic Family Medicine, 1110 W. Robinson Ave, Springdale, AR 72764 | 2018-05-04 |
| 1649726878 | Ember Estelle Lanuti Brown | Speech-Language Pathologist | 4209 Navajo Court, Springdale, AR 72764 | 2016-08-28 |
| 1568838241 | Elayna Wells | Speech-Language Pathologist | 900 S Powell Street, Springdale, AR 72764 | 2015-08-17 |
| 1184003261 | Okeyo Oghina | Nurse Practitioner | 609 West Maple Avenue, Northwest Health System, Springdale, AR 72764 | 2015-05-22 |
| 1235524869 | William M Rogers | Family Medicine | 513 N. Shiloh Street, Springdale, AR 72764 | 2015-03-31 |
| 1336498872 | Kelly Meeann Miller | Speech-Language Pathologist | 105 S Blair Street, Springdale, AR 72764 | 2012-08-30 |
| 1902183874 | Cristy Hoffman | Physical Therapy Assistant | 2837 American St Ste A, Springdale, AR 72764 | 2011-11-07 |
| Find all providers in zip 72764 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588213771 | Wendy Joanne Hart | Nurse Practitioner | 601 W Maple Ave Ste 703, Springdale, AR 72764-5378 | 2019-09-10 |
| 1114946449 | Kenneth Wayne Goff | Nurse Practitioner | 901 Jones Rd, Springdale, AR 72762-0875 | 2006-07-18 |
| 1124353982 | Jessica Marie Brandon | Nurse Practitioner | 2601 Gene George Blvd, Springdale, AR 72762 | 2009-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538285 | Matthew Barnett | Nurse Practitioner | 63 Dalton Dr, Cave City, AR 72521-9308 | 2020-11-05 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1528691912 | Rachel Wetherington | Nurse Practitioner | 9501 Baptist Health Dr Ste 500, Little Rock, AR 72205-6225 | 2020-02-13 |
| 1932749561 | Jennifer Breathitt | Nurse Practitioner | 4542 W Wedge Dr, Fayetteville, AR 72704-7532 | 2020-01-11 |
| 1124666482 | Martha Lynn Brawner | Nurse Practitioner | 2882 N Bermuda Ave, Fayetteville, AR 72704-6034 | 2019-12-18 |
| 1366089740 | Katelyn Layne Ledbetter | Nurse Practitioner | 8 Summerwood Dr, Benton, AR 72019-1925 | 2019-12-05 |
| 1235796145 | Nickey Noid | Nurse Practitioner | 1709 Cedar Dr, Bryant, AR 72019-6378 | 2019-05-26 |
| 1083175848 | Lisa Renee Bridges | Nurse Practitioner | 423 Magnolia St, Marion, AR 72364-2811 | 2019-03-26 |
| 1922566785 | Amanda Mcclure | Nurse Practitioner | 6801 Rogers Ave Fl 3, Fort Smith, AR 72903-4067 | 2019-03-11 |
| 1154898005 | Jill Kirsten Morphew | Nurse Practitioner | 1028 N Camelia St, Greenwood, AR 72936-3237 | 2018-10-30 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGDALE |
| Zip Code | 72764 |
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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.