Individual provider · Type 1 NPI
Kelly Renee Moore, AGPCNP-BC
Gerontology Nurse Practitioner · St. Louis, MO
NPI number
1780128942
Active
Practice location
100 S 4th St Ste 1000
St. Louis, MO 63102-1825
Fax (855) 737-5542
Mailing address
12900 Park Plaza Dr Ste 150
Cerritos, CA 90703-9329
Other practice locations
- 233 S Wacker Dr Ste 3700, Chicago, IL 60606-6382 · (847) 448-0400
- 12421 Meredith Dr Ste 130, Urbandale, IA 50323-4000 · (515) 219-3783
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | 2016029955 (MO) |
| Adult Health Nurse Practitioner | 363LA2200X | H158697 (IA) |
| Adult Health Nurse Practitioner | 363LA2200X | 209015105 (IL) |
Gerontology Nurse Practitioner: Definition to come...
Another provider at this address
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- Molly Marie Hulsen, ACNPGerontology Nurse Practitioner St. Louis, MO NPI 1023529468
- Kimberly Marie Boyer Hunt, FNP, AGACNPGerontology Nurse Practitioner St. Louis, MO NPI 1033601356
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About NPI 1780128942
Kelly Renee Moore, AGPCNP-BC's National Provider Identifier is 1780128942, issued on Dec 7, 2016. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in St. Louis, MO. The record was last updated on Oct 22, 2026.