Moore, Kathleen D
Moore, Kathleen D is an individual health care provider with primary practice located at 4864 Jackson St , Monroe LA 71202-6400. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Moore, Kathleen D can be contacted via phone (318) 330-7626.Contact Information
Primary practice address
4864 Jackson St
Monroe LA 71202-6400
Phone: (318) 330-7626
Fax: (318) 330-7648
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN042413-2796 | Louisiana |
Profile Details
| NPI number | 1205975844 |
|---|---|
| LBN Legal business name | Moore, Kathleen D |
| Credentials | Certified Nurse Practitioner (CNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2007 |
| Last updated | Feb 29th, 2008 - about 16 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 | 1205975844 | NPPES |
| Louisiana | MEDICAID | 1541834 |
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