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NPI Code Detail

MEDICARE: HANNAH MARIE MOORE CNP

MEDICARE: HANNAH MARIE MOORE CNP
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
1363LA2200XAdult Health Nurse PractitionerCOA.13721-NPOH
2363LA2200XAdult Health Nurse PractitionerAPRN.CNP.13721OH

Other Identifiers

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

General Provider Information

NPI Number : 1427309202
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH MARIE MOORE CNP
Provider Business Mailing Address
First Line : 1 PRESTIGE PL STE 550
Second Line :
City : MIAMISBURG
State : OH
Zip : 45342-6115
Country : US
Telephone Number : 937-762-1305
Fax Number : 937-522-7513
Provider Business Practice Location Address
First Line : 2132 E 3RD ST
Second Line :
City : DAYTON
State : OH
Zip : 45403-1991
Country : US
Telephone Number : 937-528-6850
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2012
Last Update Date : 01/12/2021

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