Healthcare Provider Details

I. General information

NPI: 1841431277
Provider Name (Legal Business Name): KRISTY STRICKLAND MOORE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2009
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11954 BOYETTE RD
RIVERVIEW FL
33569-5601
US

IV. Provider business mailing address

11954 BOYETTE RD
RIVERVIEW FL
33569-5601
US

V. Phone/Fax

Practice location:
  • Phone: 813-672-2243
  • Fax: 813-672-2245
Mailing address:
  • Phone: 813-672-2243
  • Fax: 813-672-2245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11043149
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: