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NPI Code Detail

MEDICARE: JOHN A. MOORE CRNA

MEDICARE: JOHN A. MOORE CRNA
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
1367500000XCertified Registered Nurse AnesthetistR53384NM
2367500000XCertified Registered Nurse AnesthetistCRNA1063AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00347089OTHERRR MEDICARE

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 : 1528028537
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN A. MOORE CRNA
Provider Business Mailing Address
First Line : 3501 E SPEEDWAY BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85716-3917
Country : US
Telephone Number : 520-833-5171
Fax Number : 888-395-3034
Provider Business Practice Location Address
First Line : 1171 W TARGET RANGE RD
Second Line :
City : NOGALES
State : AZ
Zip : 85621-2415
Country : US
Telephone Number : 520-287-4747
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 09/03/2025

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