Healthcare Provider Details

I. General information

NPI: 1962318451
Provider Name (Legal Business Name): MOORE COMMUNITY MEDICAL RESOURCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1544 NOE RD
LARKSPUR CO
80118-6309
US

IV. Provider business mailing address

1544 NOE RD
LARKSPUR CO
80118-6309
US

V. Phone/Fax

Practice location:
  • Phone: 303-263-5334
  • Fax: 303-263-5334
Mailing address:
  • Phone: 303-263-5334
  • Fax: 303-263-5334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: KELSEY TARTLER
Title or Position: OWNER
Credential: RN
Phone: 303-263-5334