MRS. KELLY MARIE MOORE (NPI# 1629632229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629632229 |
| Entity Type | Individual |
| Full Name | MRS. KELLY MARIE MOORE |
| Credential | APRN, NP |
| Practice Address |
12142 S Yukon Ave Glenpool OK 74033-6621 |
| Practice Telephone | 9189353636 |
| Practice Fax Number | 9182967934 |
| Mailing Telephone | 9189353636 |
| Mailing Fax Number | 9182967934 |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2019-04-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
R0109418 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457901233 | Kelly Lynn Moore | Counselor | 11111 E Mississippi Ave Ste 268, Aurora, CO 80012-3106 | 2019-09-13 |
| 1962981563 | Kelly Moore | Massage Therapist | 1776 S Jackson St Ste 830, Denver, CO 80210-3807 | 2018-08-14 |
| 1134619018 | Kelly Michelle Moore | Social Worker | 446 Pinecrest Cir, Long Beach, MS 39560-3639 | 2018-05-16 |
| 1932630902 | Kelly Moore | Optometrist | 1611 Plummer St #112e, North Hills, CA 91403-2036 | 2017-03-22 |
| 1780128942 | Kelly Renee Moore | Nurse Practitioner | 224 Margaret Michelle Ct, Saint Peters, MO 63376-4812 | 2016-12-07 |
| 1568817369 | Kelly Moore | Skilled Nursing Facility | 29 Nonotuck Rd, West Springfield, MA 01089-1616 | 2016-04-28 |
| 1588042980 | Kelly Moore | Registered Nurse | 1507 Broad Blvd, Cuyahoga Falls, OH 44223-2434 | 2015-05-18 |
| 1770977563 | Kelly Moore | Registered Nurse | 1120 Huffman Rd Ste 24-787, Anchorage, AK 99515-3516 | 2015-03-19 |
| 1790106342 | Kelly Ann Moore | Behavioral Analyst | 17845 Ridgeland Ave, Tinley Park, IL 60477-4383 | 2013-12-29 |
| 1720327570 | Kelly Moore | Occupational Therapy Assistant | 1848 E Gemini Dr, Tempe, AZ 85283-6000 | 2013-02-13 |
| Street Address |
12142 S YUKON AVE |
| City | GLENPOOL |
| State | OK |
| Zip Code | 74033-6621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790833481 | Chad P Edwards | Emergency Medicine | 12142 S Yukon Ave, Glenpool, OK 74033 | 2007-01-08 |
| 1497263818 | Transformation Health Pllc | Family Medicine | 12142 S Yukon Ave, Glenpool, OK 74033 | 2018-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033736657 | Genscripts Glenpool, LLC | Pharmacy | 12100 South Yukon Avenue, Suite A, Glenpool, OK 74033 | 2020-06-30 |
| 1982194908 | Glenpool Pain Management LLC | Pain Medicine | 148 W Main St Ste A, Glenpool, OK 74033 | 2018-05-15 |
| 1407376981 | Increasing Tranquility LLC | Clinic/Center | 519 E. 141st St., Suite L, Glenpool, OK 74033 | 2017-06-26 |
| 1528446804 | Teresa Hardesty | Internal Medicine | 140 West 151st St S, Ste 202, Glenpool, OK 74033 | 2015-05-07 |
| 1619228814 | Insight Eyecare Pllc | Optometrist | 12140 South Waco Avenue, Glenpool, OK 74033 | 2012-09-27 |
| 1366505448 | Glenpool Eye Care, Pllc | Optometrist | 247 E. 141st St., Glenpool, OK 74033 | 2006-12-19 |
| 1750440129 | Glenpool Pharmacy Inc | Pharmacy | 262 E 141st Street, Glenpool, OK 74033 | 2006-12-08 |
| 1477629293 | Gerhard Fischer | Dentist | 464 E 141st St., Glenpool, OK 74033 | 2006-11-24 |
| 1912089764 | John L Gosnell | Optometrist | 247 E 141st St., Glenpool, OK 74033 | 2006-10-20 |
| 1619071164 | Donna J Price | Family Medicine | 159 W. 146th St, Ste 4, Glenpool, OK 74033 | 2006-09-12 |
| Find all providers in zip 74033 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265050934 | Kelly Elise White | Nurse Practitioner | 3500 Healthplex Pkwy Ste 200, Norman, OK 73072-9738 | 2020-07-09 |
| 1801418991 | Brooke Elizabeth Young | Nurse Practitioner | 825 Ne 10th St Ste 2g, Oklahoma City, OK 73104-5417 | 2020-05-11 |
| 1790315729 | Robin Annette Dockins | Nurse Practitioner | 11404 Bluff Creek Dr, Oklahoma City, OK 73162-3725 | 2020-01-17 |
| 1174178784 | Chelsea Monique Ritzendollar | Nurse Practitioner | 3946 U.S. Highway 270, Fort Supply, OK 73841-9718 | 2019-08-09 |
| 1194283424 | Nancy Ann Owens | Nurse Practitioner | 5101 Sw 120th Ct, Oklahoma City, OK 73173-8875 | 2019-03-05 |
| 1528526084 | Cheryl Renee Partridge | Nurse Practitioner | 16161 Moffat Rd., Lexington, OK 73051 | 2019-03-04 |
| 1457824161 | Dawn Medi Spa, Inc | Nurse Practitioner | 1243 South Harvard Ave, Dawn Medi Spa, Inc, Tulsa, OK 74112 | 2019-01-04 |
| 1487125282 | Michael Scott Eskew | Nurse Practitioner | 14100 Parkway Commons Dr Ste 100, Oklahoma City, OK 73134-6036 | 2018-12-06 |
| 1114494077 | Crystal Jean Oneal | Nurse Practitioner | 10337 Paisley Rd, Yukon, OK 73099-7859 | 2018-10-30 |
| 1073099503 | Tracy Elaine Lane | Nurse Practitioner | 20169 E 960 Rd, Hammon, OK 73650-5032 | 2018-07-18 |
| Find all providers with the same taxonomy | ||||
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| 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.