Individual provider · Type 1 NPI

Shane Moore

Family Nurse Practitioner · Waco, TX

NPI number 1417426529 Active

Practice location

7030 New Sanger Ave Ste 204
Waco, TX 76712-4074

Call (254) 245-9175 Map

Fax (254) 213-7771

Mailing address

PO Box 11538
Killeen, TX 76547-1538

Other practice locations

  • 2304 Marketplace Dr, Waco, TX 76711-2467 · (254) 202-7300

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XAP139172 (TX)

Family Nurse Practitioner: Definition to come...

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About NPI 1417426529

Shane Moore's National Provider Identifier is 1417426529, issued on Nov 19, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Waco, TX. The record was last updated on Oct 14, 2020.