MRS. TINA MARIE MOE (NPI# 1912157041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912157041 |
| Entity Type | Individual |
| Full Name | MRS. TINA MARIE MOE |
| Credential | FNP |
| Practice Address |
109 Leroux Drive Doniphan MO 63935 |
| Mailing Address |
Po Box 1960 Jonesboro AR 72403-1960 |
| Practice Telephone | 5739962136 |
| Practice Fax Number | 5739963105 |
| Mailing Telephone | 8709361000 |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2020-02-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
152864 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
109 LEROUX DRIVE |
| City | DONIPHAN |
| State | MO |
| Zip Code | 63935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881694685 | Southeast Health Center of Ripley County | Clinic/Center | 109 Leroux Drive, Doniphan, MO 63935-1277 | 2005-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235647629 | Reorganized School Dist 4 | Local Education Agency (LEA) | Hcr 7, Box 51, Doniphan, MO 63935 | 2018-01-19 |
| 1144737206 | Amy Jo Harris | Licensed Practical Nurse | 209 W Highway St, Doniphan, MO 63935 | 2018-01-10 |
| 1518470970 | Freds of Doniphan Inc | Pharmacy | 100 H&s Drive, Doniphan, MO 63935 | 2017-11-08 |
| 1053706390 | Amazing In Home Services, LLC | In Home Supportive Care | 106 Lafayette Street, Doniphan, MO 63935 | 2015-04-03 |
| 1447649595 | Keshia J Russell | Speech-Language Pathologist | 1002 Elm Street, Doniphan, MO 63935 | 2015-01-13 |
| 1720327596 | Jessica L Eddington | Physical Therapist | 1015 Grand Street, Doniphan, MO 63935 | 2013-02-13 |
| 1700150927 | Ripley County Family Resource Center | Community/Behavioral Health | 204 Summit St., Doniphan, MO 63935 | 2012-03-06 |
| 1205107810 | Ripley County Family Resource Center | Community/Behavioral Health | 204 Summit, Doniphan, MO 63935 | 2012-01-13 |
| 1386825248 | Shopko Stores Operating Co LLC | Pharmacy | 111 Leroux Dr, Doniphan, MO 63935 | 2007-11-20 |
| 1104010081 | American Consumer Directed Services, L.L.C. | Clinic/Center | Rr 3, Box 2199, Doniphan, MO 63935 | 2007-09-04 |
| Find all providers in zip 63935 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659700995 | Bonita Hill | Nurse Practitioner | 109 Plum St, Doniphan, MO 63935-1277 | 2013-11-07 |
| 1003871393 | Ida Mccrae | Nurse Practitioner | 1 Hospital Dr, Doniphan, MO 63935-1274 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720816 | Blake Christian Cory | Nurse Practitioner | 615 S Ballas Rd # 2015, Saint Louis, MO 63122-5314 | 2020-11-08 |
| 1336740620 | Courtney J Perkins | Nurse Practitioner | 724 Sw 30th St, Blue Springs, MO 64015-3381 | 2020-11-04 |
| 1467052381 | Kristin Nersesyan | Nurse Practitioner | 916 Sw Bennington Pl, Lees Summit, MO 64081-3700 | 2020-10-29 |
| 1265032346 | Sara Lynn Gillespie | Nurse Practitioner | 2424 S 9th St Apt 215, Saint Louis, MO 63104-4717 | 2020-10-28 |
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1417556994 | Tory Linn Francis | Nurse Practitioner | 19155 Fry Rd, Edgerton, MO 64444-9037 | 2020-10-26 |
| 1174123509 | Megan Ashley Wagner | Nurse Practitioner | 10012 Kennerly Rd Ste 406, Saint Louis, MO 63128-2197 | 2020-10-26 |
| 1033718903 | Lisa Jo Moore | Nurse Practitioner | 2623 S Main Street, Nixa, MO 64804 | 2020-10-22 |
| 1831798792 | Alicia Caroline Baker | Nurse Practitioner | 1070 W 7th St, Washington, MO 63090 | 2020-10-21 |
| 1114526266 | Leslie Desha | Nurse Practitioner | 1109 Pheasant Run, Columbia, MO 65201-6253 | 2020-10-20 |
| 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.