| Moore Care Llc | |
|
400 N Eastern Ave Suite B Moore OK 73160-5833 | |
| (405) 928-2727 | |
| (405) 928-2720 |
| Full Name | Moore Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 400 N Eastern Ave, Moore, Oklahoma |
| Authorized Official Name and Position | Jessica C Deppen (OWNER) |
| Authorized Official Contact | 4059282727 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moore Care Llc 400 N Eastern Ave Suite B Moore OK 73160-5833 Ph: (405) 928-2727 | Moore Care Llc 400 N Eastern Ave Suite B Moore OK 73160-5833 Ph: (405) 928-2727 |
| NPI Number | 1104379148 |
|---|---|
| Provider Enumeration Date | 07/26/2016 |
| Last Update Date | 07/26/2016 |
| Medicare PECOS PAC ID | 3870870843 |
|---|---|
| Medicare Enrollment ID | O20170428000648 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104379148 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Corey D Finch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407903644 PECOS PAC ID: 3870774250 Enrollment ID: I20120202000898 |
| Provider Name | Jessica Deppen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659774131 PECOS PAC ID: 3779624317 Enrollment ID: I20151102002151 |
| Provider Name | Teisha Alynn Gallegly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871069724 PECOS PAC ID: 2860746195 Enrollment ID: I20181126001620 |
| Provider Name | Shehnaz Virani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639709504 PECOS PAC ID: 1850729468 Enrollment ID: I20200313001237 |
| Provider Name | Sarah Walsh |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1609393149 PECOS PAC ID: 3072944933 Enrollment ID: I20200508000039 |
| Provider Name | Ancie Madden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568069185 PECOS PAC ID: 3173916632 Enrollment ID: I20220203002571 |
| Provider Name | Natasha D Mcfalls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588299499 PECOS PAC ID: 2163839440 Enrollment ID: I20220926003554 |
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