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General NPI Number Information
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NPI Number | 1427854850
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Entity Type | Individual
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Provider Name | KRISTA LEA MOORE
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Gender | Female
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 21 E STATE ST
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City | COLUMBUS
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State | OH
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Zip | 43215-4281
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Country | US
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Telephone | 574-546-1900
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Fax | 574-546-1999
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Provider Business Mailing Address
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Address Line | 8770 WICKLOW AVE
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City | CINCINNATI
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State | OH
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Zip | 45236-1654
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Country | US
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Telephone | 513-400-7880
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Fax | 574-546-1999
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 0038737
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License Number State | OH
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