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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720188022 NPPES
Wyoming MEDICAID 123828100
Wyoming MEDICAID 35177837
Wyoming Other 314502

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