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General NPI Number Information
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NPI Number | 1508783648
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Entity Type | Individual
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Provider Name | KAVIN DUANE MOORE HIS
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Gender | Male
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 9851 S 71ST PLZ
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City | PAPILLION
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State | NE
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Zip | 68133-2244
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Country | US
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Telephone | 402-686-2397
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Fax |
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Provider Business Mailing Address
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Address Line | 3906 HEARTLAND DR
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City | BELLEVUE
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State | NE
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Zip | 68123-6238
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Country | US
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Telephone | 480-826-3617
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 841
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License Number State | NE
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