Mary Maudeana Moore, CNP | |
10 Missile Ave, Minot Afb, ND 58705-5003 | |
(701) 723-5190 | |
(701) 723-5391 |
Full Name | Mary Maudeana Moore |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 10 Years |
Location | 10 Missile Ave, Minot Afb, North Dakota |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689077927 | NPI | - | NPPES |
200558940A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 114792 (Oklahoma) | Secondary |
363LF0000X | Nurse Practitioner - Family | 1-117717 (Alabama) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Russellville Hospital Inc. | 3476878489 | 85 |
Entity Name | Advantage Family Care Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023447943 PECOS PAC ID: 7618103748 Enrollment ID: O20131120001477 |
Entity Name | Russellville Hospital Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780232314 PECOS PAC ID: 3476878489 Enrollment ID: O20191018002761 |
Mailing Address | Practice Location Address |
---|---|
Mary Maudeana Moore, CNP 130 River Rd Apt E207, Muscle Shoals, AL 35661-1338 Ph: (918) 661-6180 | Mary Maudeana Moore, CNP 10 Missile Ave, Minot Afb, ND 58705-5003 Ph: (701) 723-5190 |
Dr. Lisa Krogman, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 10 Missile Ave, Minot Afb, ND 58705 Phone: 701-723-5444 | |
Maribelle Anne Faucett, WHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10 Missile Ave, Minot Afb, ND 58705 Phone: 701-723-5633 | |
Julianne Legierse, CPNP-PC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 10 Missle Ave 5th Medical Group, Minot Afb, ND 58405 Phone: 701-723-5633 | |
Renae Rita Denelsbeck, FNP- C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 10 Missile Ave, Minot Afb, ND 58705 Phone: 701-723-5633 |