Andrea Sue Moore, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN112938 Issued in OH

Practice address

1669 Moon Rd
Greenfield, OH 45123-8227

Phone

(740) 463-6056

NPI assigned

Aug 6, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1312588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312588800000",
    "number": "1730468844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 MOON RD",
            "city": "GREENFIELD",
            "state": "OH",
            "postal_code": "451238227",
            "telephone_number": "740-463-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 MOON RD",
            "city": "GREENFIELD",
            "state": "OH",
            "postal_code": "451238227",
            "telephone_number": "740-463-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANDREA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-06",
        "last_updated": "2011-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN112938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loren E McReynolds, D.C.
• Raymond W Mick, CNP
• Danette Miller, LPCC
• Stacey Mitchell
• Richard D Mizer, MD
• Robert Daniel Mullins, RPH
• Stephanie Newman
• North Creek LLC
• David Lee Olaker Jr., RPH
• Olaker'S Apothecary, LLC.

• Licensed Practical Nurse in Greenfield, OH
• Providers in Greenfield, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2011; 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.