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General NPI Number Information
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NPI Number | 1336487081
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Entity Type | Organization
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Legal Business Name | SIMONA L MOORE CNP LLC
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Dates
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Enumeration Date | 01/30/2013
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 206 S MULBERRY ST
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City | MOUNT VERNON
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State | OH
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Zip | 43050-3331
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Country | US
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Telephone | 740-399-3008
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Fax | 740-393-3009
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Provider Business Mailing Address
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Address Line | 206 S MULBERRY ST
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City | MOUNT VERNON
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State | OH
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Zip | 43050-3331
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Country | US
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Telephone | 740-326-1231
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Fax | 740-326-1175
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Authorized Official
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Title or Position | OWNER
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Name | SIMONA LYDIA MOORE
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Credential | NP
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Telephone | 330-473-2569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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