Ann E Moore, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

UP005169B Issued in PA

Practice address

1020 Baltimore Pike
Suite 100
Glen Mills, PA 19342-1365

Phone

(484) 227-7790

Fax

(484) 227-7791

NPI assigned

Aug 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643

  Nurse Practitioner

  NPD

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501804800000",
    "number": "1508058470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 BALTIMORE PIKE",
            "address_2": "SUITE 100",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421365",
            "telephone_number": "484-227-7790",
            "fax_number": "484-227-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 BALTIMORE PIKE",
            "address_2": "SUITE 100",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421365",
            "telephone_number": "484-227-7790",
            "fax_number": "484-227-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2017-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "UP005169B",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "UP005169B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary T Mitchell, DPT
• Merrill J Mittathany, PHARMD
• Adarsh Modani, D.D.S.
• Tejal Mody, M.D.
• Vincent D Mongiovi, D.M.D.
• Jane Ruth Moore, OTRL CHT
• Joel G Moranz, MD
• Jasoni Lee Morgan, CRNP
• Christie O Mousaw, DO
• Nicole Mowbray, PSY.D

• Family Nurse Practitioner in Glen Mills, PA
• Providers in Glen Mills, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2017; 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.