Traci Moore, APRN, FNP-BC is a
Family Medicine based in Kingman, Arizona. Traci Moore is licensed to practice in Arizona (license number RNP315038) and her current practice location is
3830 N Eagle Rock Rd, Kingman, Arizona. She can be reached at her office (for appointments etc.) via phone at
(928) 377-0935.
NPI number for Traci Moore is 1225570005 and her current mailing address is 3830 N Eagle Rock Rd, Kingman, Arizona. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1225570005.
Provider's Profile
Full Name | Traci Moore |
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Gender | Female |
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Speciality | Family Medicine |
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Location | 3830 N Eagle Rock Rd, Kingman, Arizona |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1225570005
- Provider Enumeration Date: 11/10/2016
- Last Update Date: 10/02/2024
Medical Identifiers
Medical identifiers for Traci Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1225570005 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | RN186954 (Arizona) | Secondary |
163WP0808X | Registered Nurse - Psychiatric/mental Health | RN186954 (Arizona) | Secondary |
207Q00000X | Family Medicine | RNP315038 (Arizona) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Traci Moore is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Traci Moore, APRN, FNP-BC 3830 N Eagle Rock Rd, Kingman, AZ 86409-3333 Ph: (928) 377-0935 | Traci Moore, APRN, FNP-BC 3830 N Eagle Rock Rd, Kingman, AZ 86409-3333 Ph: (928) 377-0935 |
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