Healthcare Provider Details

I. General information

NPI: 1548194301
Provider Name (Legal Business Name): ANNE-MARIE MOORE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 OVERLAND LOOP
DAYTON NV
89403-8026
US

IV. Provider business mailing address

1555 MARVEL WAY UNIT 211
RENO NV
89502-6236
US

V. Phone/Fax

Practice location:
  • Phone: 775-241-2758
  • Fax:
Mailing address:
  • Phone: 775-686-0677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: