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NPI Code Detail

MEDICARE: MELISSA EILEEN MOORE L.M.

MEDICARE: MELISSA EILEEN MOORE L.M.
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
1176B00000XMidwife35MT

General Provider Information

NPI Number : 1760642144
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA EILEEN MOORE L.M.
Provider Business Mailing Address
First Line : 1545 WILLOW GLEN DR
Second Line :
City : KALISPELL
State : MT
Zip : 59901-7544
Country : US
Telephone Number : 406-261-8343
Fax Number :
Provider Business Practice Location Address
First Line : 1545 WILLOW GLEN DR
Second Line :
City : KALISPELL
State : MT
Zip : 59901-7544
Country : US
Telephone Number : 406-261-8343
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2008
Last Update Date : 01/25/2026

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