Moore, Tracey D.
Moore, Tracey D. is an individual health care provider with primary practice located at 214 E 23Rd St Cheyenne Regional Medical Center, Emergency Dept., Cheyenne WY 82001-3748. 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, Tracey D. can be contacted via phone (307) 634-2273.Contact Information
Primary practice address
214 E 23Rd St Cheyenne Regional Medical Center, Emergency Dept.
Cheyenne WY 82001-3748
Phone: (307) 634-2273
Fax: (307) 633-7671
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 175880851 | Wyoming |
Profile Details
NPI number | 1720188022 |
---|---|
LBN Legal business name | Moore, Tracey D. |
Credentials | Nurse Practitioner (NP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 25th, 2006 |
Last updated | May 11th, 2009 - 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 | 1720188022 | NPPES |
Wyoming | MEDICAID | 123828100 | |
Wyoming | MEDICAID | 35177837 | |
Wyoming | Other | 314502 |
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