Tracy Rene Moore, LPN,CSFA is a
Licensed Practical Nurse based in Shiloh, Illinois. Tracy Rene Moore is licensed to practice in Illinois (license number 043116387) and her current practice location is
1404 Cross St, Shiloh, Illinois. She can be reached at her office (for appointments etc.) via phone at
(618) 607-1000.
NPI number for Tracy Rene Moore is 1033982053 and her current mailing address is 305 Marilyn Dr, New Baden, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1033982053.
Provider's Profile
Full Name | Tracy Rene Moore |
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Gender | Female |
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Speciality | Licensed Practical Nurse |
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Location | 1404 Cross St, Shiloh, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1033982053
- Provider Enumeration Date: 11/01/2023
- Last Update Date: 11/01/2023
Medical Identifiers
Medical identifiers for Tracy Rene Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1033982053 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | 043116387 (Illinois) | 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. Tracy Rene 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 |
Tracy Rene Moore, LPN,CSFA 305 Marilyn Dr, New Baden, IL 62265-1103 Ph: (618) 698-3620 | Tracy Rene Moore, LPN,CSFA 1404 Cross St, Shiloh, IL 62269-2988 Ph: (618) 607-1000 |
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