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KIM YVETTE MOORE
NPI 1508546417
Licensed Practical Nurse in Mishawaka, IN

Active since July 25, 2023
1540 TRINITY PL, MISHAWAKA, IN 46545(574) 272-9000(574) 272-9295 Get Directions Write a Review

NPPES record last updated: July 25, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kim Yvette Moore NPPES

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

KIM YVETTE MOORE (NPI 1508546417) is an individual licensed practical nurse in Mishawaka, Indiana, licensed in Indiana (27052204A) and active in the NPI registry since July 2023.

NPPES Registry Identity

NPI1508546417
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameKIM YVETTE MOORE
Location Address1540 TRINITY PLMishawaka, IN 46545-5006
Mailing Address1540 Trinity PlMishawaka, IN 46545-5006 · (574) 272-9000 · Fax (574) 272-9295
Phone(574) 272-9000
Fax(574) 272-9295
Sole ProprietorNo
Enumeration DateJuly 25, 2023
NPPES CertifiedJuly 25, 2023
✔ NPI 1508546417 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 IN · 27052204A
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.
1540 TRINITY PL, Mishawaka, IN 46545
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. LAURA GARRIES
Pharmacist
1540 TRINITY PL
MISHAWAKA, IN 46545
St. Joseph County (574) 272-9000
CHRISTINA WETTER RN
Registered Nurse (General Practice)
1540 TRINITY PL
MISHAWAKA, IN 46545
St. Joseph County (574) 272-9000
MARY VERNON
Registered Nurse
1540 TRINITY PL
MISHAWAKA, IN 46545
St. Joseph County (574) 272-9000
JINI VARUGHESE JOHN
Optometrist
1540 TRINITY PL
MISHAWAKA, IN 46545
St. Joseph County (574) 272-9000
MRS. OLUYINKA GRACE OSUNNUGA NP
Nurse Practitioner (Psychiatric/Mental Health)
1540 TRINITY PL
MISHAWAKA, IN 46545
St. Joseph County (765) 674-3321
MARY A KERTES RPH
Pharmacist
1540 TRINITY PL
MISHAWAKA, IN 46545
St. Joseph County (574) 277-9072
LISA MICHELLE RULLI RRT
Respiratory Therapist, Registered
1540 TRINITY PL
MISHAWAKA, IN 46545
St. Joseph County (574) 272-9000
ERIKA MATTERN
Registered Nurse (General Practice)
1540 TRINITY PL
MISHAWAKA, IN 46545
St. Joseph County (574) 277-9000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kim Moore's NPI number?

The NPI number for Kim Moore is 1508546417. It was assigned to this individual provider in the NPPES registry on July 25, 2023.

Where is Kim Moore located?

Kim Moore practices at 1540 Trinity Pl, Mishawaka, IN 46545. The listed phone number is (574) 272-9000.

What is Kim Moore's specialty?

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

When was this NPI record last updated?

The NPPES record for Kim Moore was last updated on July 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.