JEANNE MOORE (NPI# 1073500658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073500658 |
| Entity Type | Individual |
| Full Name | JEANNE MOORE |
| Other Name | JEANNE MARIE CARNEY MOORE |
| Credential | NP |
| Practice Address |
2200 Tacketts Mill Dr Woodbridge Woodbridge VA 22192-3012 |
| Practice Telephone | 7034944961 |
| Mailing Telephone | 7034944961 |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2009-09-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | R 152237-0 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024168326 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SIOUX VALLEY HEALTH PLAN | 23218 | 01 | |
| MN | 984639500 | 05 | |
| PREFERRED ONE | NA2081029811 | 01 | |
| PALMETTO GBA RAILROAD MCR | 500020824 | 01 | |
| MN | BLUE CROSS BLUE SHIELD | 062J3CA | 01 |
| MEDICA | 01-07324 | 01 | |
| AMERICA'S PPO | 1651881 | 01 | |
| MN | UCARE MINNESOTA | 141044 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801212584 | Jeanne Moore | Counselor | 900 Baldwin Rd # A, Bakersfield, CA 93304-4202 | 2014-03-05 |
| 1972899367 | Jeanne I. Moore | Registered Nurse | 3137 Sonia Trl, Ellicott City, MD 21043-3276 | 2011-06-23 |
| 1790045128 | Jeanne Moore | Registered Nurse | 700 Friedman Ave, Las Vegas, NM 87701-4231 | 2012-05-18 |
| 1780814426 | Jeanne Danielle Moore | Family Medicine | 451 Duvall Ave Ne, Ste 100, Renton, WA 98059-4675 | 2009-07-15 |
| 1689762346 | Jeanne Lynn Moore | Psychologist | 30131 Town Center Drive, Suite 280, Laguna Niguel, CA 92677 | 2006-10-10 |
| 1043302516 | Jeanne E Moore | Anesthesiology | 90 West St, Apt 19-y, New York, NY 10006-1012 | 2006-09-29 |
| Street Address |
2200 TACKETTS MILL DR WOODBRIDGE |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22192-3012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790889459 | Virginia Cvs Pharmacy, L.L.C. | Pharmacy | 2200 Tacketts Mill Dr, Woodbridge, VA 22192-3012 | 2006-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245873645 | Ursula Jackson | Technician | 3500 Commission Ct, Woodbridge, VA 22192 | 2019-10-18 |
| 1205480779 | Ki Soo Park | Physical Therapy Assistant | 12825 Minnieville Road Suite 201, Lake Ridge, VA 22192 | 2019-08-01 |
| 1801448329 | Karen Lee Trivett | Specialist/Technologist, Other | 12584 Darby Brook Court, Woodbridge, VA 22192 | 2019-07-15 |
| 1407313166 | Nichele Amelia Thompson | Behavioral Analyst | 2731 Marblestone Dr, 101, Woodbridge, VA 22192 | 2019-02-28 |
| 1952877870 | Kimberly Ann Rojas Vazquez | Behavioral Analyst | 12531 Clipper Dr, Suite 203, Woodbridge, VA 22192 | 2018-10-18 |
| 1104391614 | Ykim Dental | Dentist | 2680 Optiz Blvd., Suite 120, Woodbridge, VA 22192 | 2018-10-11 |
| 1013418755 | Arm Transport | Non-emergency Medical Transport (VAN) | 13000 Harbor Center Dr Ste 132d, Woodbridge, VA 22192 | 2018-02-27 |
| 1811496813 | Francesca Nasi | Behavioral Analyst | 12531 Clipper Dr Ste 203, Woodbridge, VA 22192 | 2018-02-05 |
| 1942729504 | Bismark Transportation Service LLC | Non-emergency Medical Transport (VAN) | 12341 Woodlawn Court, Woodbridge, VA 22192 | 2017-09-14 |
| 1992226344 | Arm Baby Eldery Home Health LLC | Home Health | 13000 Harbor Center Dr # 312c, Woodbridge, VA 22192 | 2017-07-06 |
| Find all providers in zip 22192 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639797681 | Ruthzie Frazil | Nurse Practitioner | 225 Mawbey St, Woodbridge, NJ 07095-2315 | 2020-07-07 |
| 1275152035 | Jenny Lee Potter | Nurse Practitioner | 14948 Grassy Knoll Ct, Woodbridge, VA 22193-6002 | 2020-04-13 |
| 1346883220 | Sabrina Ann Salem | Nurse Practitioner | 3085 Clarkford Ct, Woodbridge, VA 22192-1107 | 2019-10-23 |
| 1831745264 | Sosina Jules | Nurse Practitioner | 5324 Satterfield Dr, Woodbridge, VA 22193-3408 | 2019-08-12 |
| 1720545452 | Shannon Marie Murley | Nurse Practitioner | 4500 Pond Way Ste 170, Woodbridge, VA 22192-5596 | 2019-02-28 |
| 1134685654 | Mabinti Kamara | Nurse Practitioner | 12770 Ripple Creek Ct Apt 2314, Woodbridge, VA 22192-6562 | 2019-02-20 |
| 1659846566 | Jennifer Couso | Nurse Practitioner | 1000 Route 9 N Ste 302, Woodbridge, NJ 07095-1200 | 2018-10-06 |
| 1467937854 | James Robert Dyson | Nurse Practitioner | 14010 Smoketown Rd # 103, Woodbridge, VA 22192-4722 | 2018-10-01 |
| 1295242469 | Victoria Afi Dzah | Nurse Practitioner | 2573 Grayton Ln, Woodbridge, VA 22191-4786 | 2018-01-09 |
| 1093228363 | Sheryl Cekot | Nurse Practitioner | 102 Cricket Ln, Woodbridge, NJ 07095-1502 | 2017-11-09 |
| Find all providers in WOODBRIDGE | ||||
| City | WOODBRIDGE |
| Zip Code | 22192 |
Please comment or provide details below to improve the information on JEANNE MOORE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.