| Doctor Name: | KELLI A MOORE |
| NPI Number: | 1841473055 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | SP009629 |
| Business Practice Address: | 1830 Good Hope Rd Enola, PA - 170251233 |
| Business Phone Number: | 7177328877 |
| Business Fax Number: | 7177329241 |
| Mailing Address: | 3 Walnut St, Suite 206 LEMOYNE |
| State: | PA |
| Postal Code: | 170431168 |
| Phone Number: | 7177610208 |
| Fax Number: | 7177612023 |
| NPI Enumeration Date: | 12/11/2007 |
| NPI Last Update Date: | 05/15/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | SP009629 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |