Moore, Pamela M

Moore, Pamela M is an individual health care provider with primary practice located at 611 W. Park St. Cardiology, Urbana IL 61801-2500. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular Surgery, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Moore, Pamela M can be contacted via phone (217) 904-7000.

Contact Information

Primary practice address
611 W. Park St. Cardiology Urbana IL 61801-2500
Phone: (217) 904-7000
Fax: (217) 904-7742
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X RN81005 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 209-006880 Illinois

Profile Details

NPI number 1881701308
LBN Legal business name Moore, Pamela M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2006
Last updated May 28th, 2014 - about 11 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 1881701308 NPPES
Other 103086 MC COCHISE
Other 300051634 MC COCHISE
Other 448664 MC COCHISE
Other 103087 MC COCHISE
Other 103087 MC COCHISE
Other 1Z1408 MC COCHISE
Other 300051634 MC COCHISE
Other 448664 MC COCHISE
Other AZ0819900 MC COCHISE
Other 300051634 MC COCHISE
Other 300051634 MC COCHISE
Other 102542 MC COCHISE
Other 103086 MC COCHISE
Other 500005593 MC COCHISE
Other 300051634 MC COCHISE
Other 448664 MC COCHISE
MEDICAID 448664 MC COCHISE

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