| Doctor Name: | MINDY MILAR MOORE |
| NPI Number: | 1174792998 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP |
| License Number: | 50112NP |
| Business Practice Address: | 230 Rowe St The Rinehart Clinic Wheeler, OR - 97147 |
| Business Phone Number: | 5033695182 |
| Business Fax Number: | 5033685590 |
| Mailing Address: | Po Box 176, WHEELER |
| State: | OR |
| Postal Code: | 971470176 |
| Phone Number: | 5033695182 |
| Fax Number: | 5033685590 |
| NPI Enumeration Date: | 02/26/2008 |
| NPI Last Update Date: | 02/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 50112NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |