Moore, Kristy D

Moore, Kristy D is an individual health care provider with primary practice located at 401 E Vaughn Ave , Ruston LA 71270-5950. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Moore, Kristy D can be contacted via phone (318) 254-2100.

Contact Information

Primary practice address
401 E Vaughn Ave Ruston LA 71270-5950
Phone: (318) 254-2100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 074320 Louisiana

Profile Details

NPI number 1891814703
LBN Legal business name Moore, Kristy D
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2007
Last updated Feb 18th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891814703 NPPES
Louisiana Other 074320 CRNA CERTIFICATION NO.
Louisiana MEDICAID 1024252 CRNA CERTIFICATION NO.
Louisiana Other H6497 CRNA CERTIFICATION NO.

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