Larry Moyer, RN
Individual provider Active NPI Registered Nurse · Holt, MO
NPI 1447583869 · NPPES record last updated Sep 16, 2009
Key facts
- NPI
- 1447583869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 2007023704 (MO)
- Practice address
- 7861 SE Freeway Farms Dr
Holt, MO 64048-8404 - Phone
- (816) 588-2897
- NPI assigned
- Sep 16, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14-104413-111 | KS | MD | Registered Nurse |
| 2007023704 | MO | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2007023704 | MO | Yes |
| Registered Nurse | 163W00000X | 14-104413-111 | KS |
Addresses
Primary practice location
7861 SE Freeway Farms Dr
Holt, MO 64048-8404
Mailing address
7861 SE Freeway Farms Dr
Holt, MO 64048-8404
Other providers in Holt, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.