Irene Moore
Nurse Practitioner
7130 N Millbrook Ave Ste 100
Fresno
, California 93720
Irene Moore
Nurse Practitioner
7130 N Millbrook Ave Ste 100
Fresno
, California 93720
(559) 326-1230
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About
Features
Specialties
- Nurse Practitioner
Languages spoken
- English
Location
First Address
- Irene Moore
- Po Box 25100
- Fresno, CA
- Zip : 93729-5100
- Fax : (559) 326-1230
- Phone : (559) 326-1222
Second Address
- Irene Moore
- 7130 N Millbrook Ave Ste 100
- Fresno, CA
- Zip : 93720
- Fax : (559) 326-1230
- Phone : (559) 326-1222
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN4177046768 | CA |
National Provider Identifier
| NPI | 1003822925 |
|---|---|
| Provider Name | Irene Moore |
| First Address | Fresno, CA 93729-5100 |
| Second Address | Fresno, CA 93720 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/07/2006 |
| Last Update Date | 27/07/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| MM1980970 | DEA (01) | CA |
| RN417704 | LICENSE NUMBER (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.