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General NPI Number Information
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NPI Number | 1740735497
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Entity Type | Individual
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Provider Name | ELIZABETH CAMERON MOORE APRN
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Gender | Female
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 818 N BROADWAY ST
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City | PITTSBURG
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State | KS
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Zip | 66762-3909
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Country | US
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Telephone | 620-303-3039
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Fax | 620-303-3039
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Provider Business Mailing Address
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Address Line | 2701 E 14TH ST
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City | JOPLIN
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State | MO
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Zip | 64801-5341
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Country | US
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Telephone | 561-723-4658
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2019027687
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License Number State | MO
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