KELLY RENEE MOORE (NPI# 1780128942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780128942 |
| Entity Type | Individual |
| Full Name | KELLY RENEE MOORE |
| Credential | NP |
| Practice Address |
224 Margaret Michelle Ct Saint Peters MO 63376-4812 |
| Practice Telephone | 3145201227 |
| Mailing Telephone | 3145201227 |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2016-12-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
209.015105 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
2016029955 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
209.015105 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
2016029955 | MO | 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 |
| 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 |
| 1578845913 | Kelly Moore | Counselor | 38 Gray St, Asheville, NC 28801-2118 | 2011-09-12 |
| Street Address |
224 MARGARET MICHELLE CT |
| City | SAINT PETERS |
| State | MO |
| Zip Code | 63376-4812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275047946 | Nicholas Christian Schultz | Dentist | 100 Piper Hill Dr Ste A, Saint Peters, MO 63376 | 2017-11-16 |
| 1982120093 | Carol Weber | Speech-Language Pathologist | 166 Boone Hills Dr., St Peters, MO 63376 | 2017-08-21 |
| 1619424744 | Forefront Dermatology, S.c. | Dermatology | 5700 Mexico Rd, Suite 14, Saint Peters, MO 63376 | 2016-09-07 |
| 1508310632 | Preferred Family Healthcare, Inc. | Counselor | 2120 Parkway Dr, Saint Peters, MO 63376 | 2016-08-05 |
| 1598130676 | Delta Center Personal Attendant Services | In Home Supportive Care | 3833 Mcclay, Suite 61, St. Peters, MO 63376 | 2015-12-01 |
| 1427420314 | Barbara Marlene Edelman | Counselor | 1286 Jungerman Rd. Suite G, St. Peters, MO 63376 | 2015-10-30 |
| 1255740247 | Claire Williams | Dentist | 340 Mid Rivers Mall Drive, Suite E, St. Peters, MO 63376 | 2014-08-05 |
| 1184042855 | Keith Wickenhauser | Internal Medicine | 201 Bjc Saint Peters Dr Ste 100, Saint Peters, MO 63376 | 2014-03-31 |
| 1821415233 | Abby Link | Physician Assistant | 107 Piper Parkway, #150, St. Peters, MO 63376 | 2014-03-24 |
| 1225452105 | Ashley Gagel | Physical Therapist | 7055 Mexico Rd Suite 1601, St. Peters, MO 63376 | 2014-02-12 |
| Find all providers in zip 63376 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639719230 | Tiffany Reed Tate-woodard | Nurse Practitioner | 408 Jungermann Rd, Saint Peters, MO 63376-2799 | 2020-01-10 |
| 1205218344 | Amy Theresa Mccory | Nurse Practitioner | 5400 Executive Centre Pkwy, Saint Peters, MO 63376-2594 | 2015-06-25 |
| 1952783227 | Sarah R Lavy | Nurse Practitioner | 112 Piper Hill Dr, Ste 12, Saint Peters, MO 63376-1690 | 2015-06-23 |
| 1619249893 | Lisa Anne Burnitt | Nurse Practitioner | 408 Jungermann Rd, Saint Peters, MO 63376-2799 | 2012-02-02 |
| 1053698969 | Laura Ann Benack | Nurse Practitioner | 150 Entrance Way, Saint Peters, MO 63376-1645 | 2011-11-05 |
| 1255633525 | Maria Harms | Nurse Practitioner | 114 Piper Hill Dr, Suite 103, Saint Peters, MO 63376-1661 | 2010-11-18 |
| 1114193083 | Jennifer L Keen | Nurse Practitioner | 6 Jungermann Cir, Suite 209, Saint Peters, MO 63376-1621 | 2008-05-01 |
| 1790972255 | Candice Griewing | Nurse Practitioner | 2730 S Highway 94, Ste 202, Saint Peters, MO 63303-5677 | 2007-09-28 |
| 1134145378 | Mary K Knight Macheca | Nurse Practitioner | 201 Bjc Saint Peters Dr, Ste 200, Saint Peters, MO 63376-3385 | 2006-07-14 |
| 1316976392 | Stephanie Marie Orlando | Nurse Practitioner | 107 Piper Hill Dr, Suite 100, Saint Peters, MO 63376-1651 | 2006-07-01 |
| Find all providers in SAINT PETERS | ||||
| City | SAINT PETERS |
| Zip Code | 63376 |
Please comment or provide details below to improve the information on KELLY RENEE 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.