KELLY THERESE MOORE RN DNP STUDENT NPI 1114516812

NPI Information

NPI: 1114516812
Provider Name: KELLY THERESE MOORE, RN, DNP STUDENT
Classification: Registered Nurse - 163WP2201X
Entity Type: Individual

Specialization: Ambulatory Care

Address:
3240 W DIVISION ST
CHICAGO, IL
ZIP 60651
Phone: (312) 413-7425
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Kelly Therese Moore, RN, DNP STUDENT is an ambulatory care registered nurse in Chicago, IL. Kelly Therese Moore, RN, DNP STUDENT NPI is 1114516812. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3240 W DIVISION ST
CHICAGO, IL
ZIP 60651-405
Phone: (312) 413-7425

The enumeration date for this NPI number is 1/16/2021 and was last updated on 1/16/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WP2201X	Registered Nurse	Ambulatory Care	041487884	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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