Individual provider · Type 1 NPI

Kim Yvette Moore

Licensed Practical Nurse · Mishawaka, IN

NPI number 1508546417 Active

Practice location

1540 Trinity Pl
Mishawaka, IN 46545-5006

Fax (574) 272-9295

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X27052204A (IN)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1508546417

Kim Yvette Moore's National Provider Identifier is 1508546417, issued on Jul 25, 2023. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Mishawaka, IN. The record was last updated on Jul 25, 2023.