JERRY MOORE SR. - NPI 1033368790 - Licensed Practical Nurse in Springfield, MA

Q: What is Jerry Moore's NPI number?

The NPI number for Jerry Moore is 1033368790. It was assigned to this individual provider in the NPPES registry on September 17, 2008.

Q: What is Jerry Moore's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Q: When was this NPI record last updated?

The NPPES record for Jerry Moore was last updated on September 17, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Jerry Moore Sr. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERRY MOORE SR. (NPI 1033368790) is an individual licensed practical nurse in Springfield, Massachusetts, licensed in Massachusetts (33527) and active in the NPI registry since September 2008.

NPPES Registry Identity

NPI1033368790

Entity TypeIndividualMale

Primary Taxonomy164W00000X

Provider Legal NameJERRY MOORE SR.

Location Address417 LIBERTY STSpringfield, MA 01104-3736

Mailing Address417 Liberty StSpringfield, MA 01104-3736 · (413) 747-0705 · Fax (413) 732-7075

Phone(413) 747-0705

Fax(413) 732-7075

Sole ProprietorNo

Enumeration DateSeptember 17, 2008

✔ NPI 1033368790 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers

Taxonomy Code164W00000X

License✔ Licensed in MA · 33527

Definition

A licensed practical nurse 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.

417 LIBERTY ST, Springfield, MA 01104

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