Jordan Russell Moore, | |
206 S Mulberry St, Mount Vernon, OH 43050-3331 | |
(740) 399-3008 | |
Not Available |
Full Name | Jordan Russell Moore |
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Gender | Male |
Speciality | Nurse Practitioner - Family |
Location | 206 S Mulberry St, Mount Vernon, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1821651571 | NPI | - | NPPES |
APRN.CNP.025092 | Other | OH | STATE LICENSE NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | APRN.CNP.025092 (Ohio) | Primary |
Entity Name | North Central Ohio Family Care Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1689822827 PECOS PAC ID: 3274437082 Enrollment ID: O20031124000232 |
Entity Name | Knox County General Health District |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306818075 PECOS PAC ID: 8820078595 Enrollment ID: O20040722001116 |
Entity Name | Simona L Moore Cnp Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1336487081 PECOS PAC ID: 3971748716 Enrollment ID: O20130326000413 |
Mailing Address | Practice Location Address |
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Jordan Russell Moore, 206 S Mulberry St, Mount Vernon, OH 43050-3331 Ph: (740) 399-3008 | Jordan Russell Moore, 206 S Mulberry St, Mount Vernon, OH 43050-3331 Ph: (740) 399-3008 |
Tabitha Marrie Baughman, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 180 Birch St, C, Mount Vernon, OH 43050 Phone: 740-501-4705 | |
Alyssa Romanko, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 503 Wooster Rd, Mount Vernon, OH 43050 Phone: 740-326-6552 | |
Kori L Kirkhope, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1330 Coshocton Ave, Mount Vernon, OH 43050 Phone: 740-393-9000 Fax: 740-392-0167 | |
Laura Eichenlaub, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1330 Coshocton Ave, Mount Vernon, OH 43050 Phone: 740-393-9000 | |
Mrs. Jill Hunter, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1330 Coshocton Ave, Mount Vernon, OH 43050 Phone: 740-393-9000 | |
Autumn Marie Wichterman, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8402 Blackjack Rd, Mount Vernon, OH 43050 Phone: 419-565-6772 | |
Mrs. Kristin E Baker, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1330 Coshocton Ave, Kch Wright Family Medical Pavilion Dept Of Specialty Ca, Mount Vernon, OH 43050 Phone: 740-397-5400 Fax: 740-399-3706 |