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General NPI Number Information
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NPI Number | 1396748752
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Entity Type | Individual
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Provider Name | CYNTHIA LYNNE MOORE APRN
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Gender | Female
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 7405 RENNER RD
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City | SHAWNEE
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State | KS
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Zip | 66217-9414
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Country | US
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Telephone | 913-588-2200
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Fax | 913-588-8423
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Provider Business Mailing Address
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Address Line | 6955 GREENWOOD ST
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City | SHAWNEE
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State | KS
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Zip | 66216-3905
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Country | US
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Telephone | 816-589-3464
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 44641
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License Number State | KS
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