Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2314 | IA |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | 2314 | IA |
NPI | 1003879727 |
---|---|
Provider Name | Dr. Kristen Lynn Moyer |
First Address | Prairie Village, KS 66208-2583 |
Second Address | Kansas City, MO 64128-2226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2006 |
Last Update Date | 27/01/2012 |