| Doctor Name: | TINA L. MOORE |
| NPI Number: | 1851483523 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN, BC-FNP |
| License Number: | 141409 |
| Business Practice Address: | 216 W Main St Steele, MO - 638771436 |
| Business Phone Number: | 5736952181 |
| Business Fax Number: | 5736952796 |
| Mailing Address: | 216 W Main St, STEELE |
| State: | MO |
| Postal Code: | 638771436 |
| Phone Number: | 5736952181 |
| Fax Number: | 5736952796 |
| NPI Enumeration Date: | 09/29/2006 |
| NPI Last Update Date: | 10/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 141409 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |