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General NPI Number Information
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NPI Number | 1962227389
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Entity Type | Individual
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Provider Name | KATHRYN ELIZABETH MOORE RN
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Gender | Female
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 4217 ZAGAR DR
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City | CINCINNATI
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State | OH
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Zip | 45245-1609
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Country | US
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Telephone | 859-609-3041
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Fax |
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Provider Business Mailing Address
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Address Line | 4217 ZAGAR DR
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City | CINCINNATI
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State | OH
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Zip | 45245-1609
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Country | US
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Telephone | 859-609-3041
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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 | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 505426
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 1175636
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License Number State | KY
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