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General NPI Number Information
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NPI Number | 1598680274
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Entity Type | Individual
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Provider Name | KIMBERLY ANN MOORE
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Gender | Female
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Dates
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Enumeration Date | 08/12/2026
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Last Update Date | 08/12/2026
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Provider Practice Location Address
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Address Line | 179 INDEPENDENCE RD
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-9207
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Country | US
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Telephone | 908-956-2789
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Fax |
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Provider Business Mailing Address
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Address Line | 18 ACE LN
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-8031
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Country | US
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Telephone | 908-956-2789
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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 | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | 26NR18519500
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License Number State | NJ
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