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NPI Code Detail

MEDICARE: MRS. CYNTHIA SUE MOORE RN CFNP

MEDICARE: MRS. CYNTHIA SUE MOORE RN CFNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner35438WV

General Provider Information

NPI Number : 1164589958
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CYNTHIA SUE MOORE RN CFNP
Provider Business Mailing Address
First Line : 324 CHICHESTER LN
Second Line :
City : PARKERSBURG
State : WV
Zip : 26104-8513
Country : US
Telephone Number : 304-464-5284
Fax Number : 304-422-7374
Provider Business Practice Location Address
First Line : 911 EMERSON AVE
Second Line :
City : PARKERSBURG
State : WV
Zip : 26104-2526
Country : US
Telephone Number : 304-422-7357
Fax Number : 304-422-7374
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2007
Last Update Date : 07/08/2007

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