Moe, Kali Jo
Moe, Kali Jo is an individual health care provider with primary practice located at 1237 E Main St , Carbondale IL 62901-3148. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Moe, Kali Jo can be contacted via phone (618) 457-2281.Contact Information
Primary practice address
1237 E Main St
Carbondale IL 62901-3148
Phone: (618) 457-2281
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 340962 | New York |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 209021379 | Illinois |
Profile Details
NPI number | 1790238160 |
---|---|
LBN Legal business name | Moe, Kali Jo |
Credentials | FNP-C |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 2nd, 2016 |
Last updated | Dec 28th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1790238160 | NPPES |
New York | MEDICAID | 04546549 |
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