| Doctor Name: | CHRISTINA MOORE |
| NPI Number: | 1306222922 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | ARNP9415648 |
| Business Practice Address: | 785 S 2nd St Defuniak Springs, FL - 324354903 |
| Business Phone Number: | 8508922176 |
| Business Fax Number: | 8508920781 |
| Mailing Address: | 12201 Bluegrass Pkwy, LOUISVILLE |
| State: | KY |
| Postal Code: | 402992361 |
| Phone Number: | 5025687364 |
| Fax Number: | 5025687136 |
| NPI Enumeration Date: | 08/05/2015 |
| NPI Last Update Date: | 08/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | ARNP9415648 |
| 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: | |