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General NPI Number Information
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NPI Number | 1003879727
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Entity Type | Individual
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Provider Name | KRISTEN LYNN MOYER O.D.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 01/27/2012
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Provider Practice Location Address
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Address Line | 4801 E LINWOOD BLVD
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City | KANSAS CITY
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State | MO
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Zip | 64128-2226
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Country | US
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Telephone | 816-861-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 4419 W 71ST ST
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-2583
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2314
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 2314
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License Number State | IA
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