MEDICARE: KAREN GREEN MOORE WHNP

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
1	363LW0102X	Women's Health Nurse Practitioner	AP08227	LA
2	163WW0101X	Ambulatory Women's Health Care Registered Nurse	RN062095	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407248255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN GREEN MOORE WHNP

Provider Business Mailing Address
First Line	:	4600 GULF FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77023-3548
Country	:	US
Telephone Number	:	713-831-6554
Fax Number	:	713-535-2554

Provider Business Practice Location Address
First Line	:	4018 MAGAZINE ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-2749
Country	:	US
Telephone Number	:	504-897-9200
Fax Number	:	404-494-7433

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2015
Last Update Date	:	11/18/2015

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