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NPI Code Detail

MEDICARE: KYLA ELAINE MOORE APRN

MEDICARE:   KYLA ELAINE MOORE  APRN
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
1363LG0600XGerontology Nurse PractitionerAPN.0996891-NPCO
2363LA2100XAcute Care Nurse Practitioner116172OK

General Provider Information

NPI Number : 1649745654
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLA ELAINE MOORE APRN
Provider Business Mailing Address
First Line : 2695 ROCKY MOUNTAIN AVE STE 150
Second Line :
City : LOVELAND
State : CO
Zip : 80538-9071
Country : US
Telephone Number : 719-364-6487
Fax Number : 719-364-6488
Provider Business Practice Location Address
First Line : 1400 E BOULDER ST STE 500
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-5533
Country : US
Telephone Number : 719-364-6487
Fax Number : 719-364-6488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2018
Last Update Date : 05/28/2026

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