Moore, Jeanne

Moore, Jeanne is an individual health care provider with primary practice located at 2200 Tacketts Mill Dr Woodbridge, Woodbridge VA 22192-3012. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Moore, Jeanne can be contacted via phone (703) 494-4961.

Contact Information

Primary practice address
2200 Tacketts Mill Dr Woodbridge Woodbridge VA 22192-3012
Phone: (703) 494-4961
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R 152237-0 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024168326 Virginia

Profile Details

NPI number 1073500658
LBN Legal business name Moore, Jeanne
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2005
Last updated Sep 16th, 2009 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073500658 NPPES
Other 23218 SIOUX VALLEY HEALTH PLAN
MEDICAID 984639500 SIOUX VALLEY HEALTH PLAN
Other 1651881 SIOUX VALLEY HEALTH PLAN
Other 141044 SIOUX VALLEY HEALTH PLAN
Other 500020824 SIOUX VALLEY HEALTH PLAN
Other 01-07324 SIOUX VALLEY HEALTH PLAN
Other 062J3CA SIOUX VALLEY HEALTH PLAN
Other NA2081029811 SIOUX VALLEY HEALTH PLAN

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