Kathleen D Moore, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN042413-2796 Issued in LA

Practice address

4864 Jackson St
Monroe, LA 71202-6400

Phone

(318) 330-7626

Fax

(318) 330-7648

NPI assigned

Feb 6, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1205975844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4864 JACKSON ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712026400",
            "telephone_number": "318-330-7626",
            "fax_number": "318-330-7648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4864 JACKSON ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712026400",
            "telephone_number": "318-330-7626",
            "fax_number": "318-330-7648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KATHLEEN",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "RN042413-2796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1541834",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystell Moore
• Daniel L. Moore, PH.D.
• Debra Shelia Moore
• Holly Kebodeaux Moore, L-SLP; CCC-SLP
• Kareem Moore
• Precious Latrice Moore
• Rheagan Ross Moore
• Roxanne Moore
• Sherri Moore
• Shy'Kierria Moore

• Family Nurse Practitioner in Monroe, LA
• Providers in Monroe, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.