| Doctor Name: | MS. VICKI HURLEY MOORE |
| NPI Number: | 1215020920 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | AO1821 |
| Business Practice Address: | 500 S Mount Olive St Suite 200 Siloam Springs, AR - 727613602 |
| Business Phone Number: | 4795249550 |
| Business Fax Number: | 4795249552 |
| Mailing Address: | 614 E Emma Ave, Suite 300 SPRINGDALE |
| State: | AR |
| Postal Code: | 727644634 |
| Phone Number: | 4797517417 |
| Fax Number: | 4797514898 |
| NPI Enumeration Date: | 10/02/2006 |
| NPI Last Update Date: | 11/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AO1821 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |