MS. MARSHA ANN MOORE, NP - NPI NUMBER 1396813598

Summary

Provider Name: MS. MARSHA ANN MOORE, NP

NPI Number: 1396813598

Clasification: Nurse Practitioner (363L00000X)

Organization: MINERS' COLFAX MEDICAL CENTER

Address:
142 S 1ST ST
RATON, NM
ZIP 87740

Phone Number: (575) 445-2753



Detailed Information

MS. Marsha Ann Moore, NP is a nurse practitioner in Raton, NM with 16 years of experience. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. The assigned NPI number for this provider is 1396813598 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

142 S 1ST ST
RATON, NM
ZIP 87740-902
Phone: (575) 445-2753
Fax: (575) 445-2759

The enumeration date for this NPI number is 12/4/2006 and was last updated on 1/8/2013.

Map - Location of Practice

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Taxonomy Codes

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 363L00000X Nurse Practitioner R38356 NM Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 S36035 MEDICARE UPIN NM
2 00071062 MEDICAID NM

NPI Record

No. Field Name Field Value
1 NPI 1396813598
2 Entity Type Code 1
3 Provider Last Name Legal Name MOORE
4 Provider First Name MARSHA
5 Provider Middle Name ANN
6 Provider Name Prefix Text MS.
7 Provider Credential Text NP
8 Provider First Line Business Practice Location Address 142 S 1ST ST
9 Provider Business Practice Location Address City Name RATON
10 Provider Business Practice Location Address State Name NM
11 Provider Business Practice Location Address Postal Code 877403902
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 5754452753
14 Provider Business Practice Location Address Fax Number 5754452759
15 Provider Enumeration Date 12/4/2006
16 Last Update Date 1/8/2013
17 Provider Gender Code F
18 Healthcare Provider Taxonomy Code 1 363L00000X
19 Provider License Number 1 R38356
20 Provider License Number State Code 1 NM
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Other Provider Identifier 1 S36035
23 Other Provider Identifier Type Code 1 02
24 Other Provider Identifier State 1 NM
25 Other Provider Identifier 2 00071062
26 Other Provider Identifier Type Code 2 05
27 Other Provider Identifier State 2 NM
28 Is Sole Proprietor Y

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This page was last updated on: 11/14/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.