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NPI Code Detail

MEDICARE: MAUREEN C MOORE

MEDICARE: MAUREEN C MOORE
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 PractitionerNP-3071CO
2363LF0000XFamily Nurse PractitionerNP-3071CO
3163W00000XRegistered NurseRN-6552CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P01148022OTHERCORAILROAD MEDICARE PIN
3P00944802OTHERCOMEDICARE RAILROAD CARRIER PTAN

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 : 1619953734
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAUREEN C MOORE
Provider Business Mailing Address
First Line : PO BOX 912215
Second Line :
City : DENVER
State : CO
Zip : 80291-2215
Country : US
Telephone Number : 303-306-7783
Fax Number : 303-306-7753
Provider Business Practice Location Address
First Line : 1024 S LEMAY AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-3929
Country : US
Telephone Number : 303-306-7783
Fax Number : 303-306-7753
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2005
Last Update Date : 03/07/2014

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Directions to “ MAUREEN C MOORE ” Practice Location

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