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NPI Code Detail

MEDICARE: MARJORIE S MOORE FNP

MEDICARE: MARJORIE S MOORE FNP
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
1363L00000XNurse Practitioner204130LA
2363LF0000XFamily Nurse Practitioner204130LA

General Provider Information

NPI Number : 1518526896
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARJORIE S MOORE FNP
Provider Business Mailing Address
First Line : 5959 S SHERWOOD FOREST BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-6038
Country : US
Telephone Number : 225-313-3930
Fax Number : 225-765-9196
Provider Business Practice Location Address
First Line : 14350 HIGHWAY 73
Second Line :
City : PRAIRIEVILLE
State : LA
Zip : 70769-3617
Country : US
Telephone Number : 225-313-3930
Fax Number : 225-313-3940
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2019
Last Update Date : 01/22/2026

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Directions to “ MARJORIE S MOORE FNP” Practice Location

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