| Doctor Name: | KIMBERLY MOORE |
| NPI Number: | 1235527508 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | ARNP 9183587 |
| Business Practice Address: | 10484 Stringfellow Rd Suite 1 St James City, FL - 339563208 |
| Business Phone Number: | 2392835200 |
| Business Fax Number: | 2392837620 |
| Mailing Address: | 3434 Hancock Bridge Pkwy, Ste 301 NORTH FORT MYERS |
| State: | FL |
| Postal Code: | 339037094 |
| Phone Number: | 8778563774 |
| Fax Number: | 2395992625 |
| NPI Enumeration Date: | 01/08/2015 |
| NPI Last Update Date: | 06/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | ARNP 9183587 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |