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General NPI Number Information
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NPI Number | 1578819728
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Entity Type | Individual
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Provider Name | JACQUELYN MARIE MOORE PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 1649 MAIN ST
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City | BILLINGS
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State | MT
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Zip | 59105-4043
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Country | US
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Telephone | 406-254-2947
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Fax |
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Provider Business Mailing Address
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Address Line | 1649 MAIN ST
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City | BILLINGS
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State | MT
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Zip | 59105-4043
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Country | US
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Telephone | 406-254-2947
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18503
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | P6746
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 70425
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 6655
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License Number State | MT
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