SANDRA LEE MOORE AGACNP APRN NPI 1710504931

NPI Information

NPI: 1710504931
Provider Name: SANDRA LEE MOORE, AGACNP, APRN
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
609 W MAPLE AVE
SPRINGDALE, AR
ZIP 72764
Phone: (479) 757-1260
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Sandra Lee Moore, AGACNP, APRN is an acute care nurse practitioner in Springdale, AR. Sandra Lee Moore, AGACNP, APRN NPI is 1710504931. 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:

609 W MAPLE AVE
SPRINGDALE, AR
ZIP 72764-335
Phone: (479) 757-1260

The NPI 1710504931 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/3/2020 and was last updated on 10/12/2020.

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	363LA2100X	Nurse Practitioner	Acute Care	124033	ARKANSAS	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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