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ANDREA DIANE MOORE FNP-BC
NPI 1710645544
Nurse Practitioner - Family in Jacksonville, IL

Active since November 29, 2021
425 E STATE ST, JACKSONVILLE, IL 62650(217) 408-1195 Get Directions Write a Review

NPPES record last updated: January 9, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 9, 2026, Feb 23, 2022, Nov 29, 2021 (3 updates tracked since 2021).

About Andrea Diane Moore Fnp-bc NPPES

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

ANDREA DIANE MOORE FNP-BC (NPI 1710645544) is an individual family provider in Jacksonville, Illinois, licensed in Illinois (2021039559) and active in the NPI registry since November 2021.

NPPES Registry Identity

NPI1710645544
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameANDREA DIANE MOORECredential: FNP-BC
Location Address425 E STATE STJacksonville, IL 62650-2125
Mailing Address425 E State StJacksonville, IL 62650-2125
Phone(217) 408-1195
Sole ProprietorYes
Enumeration DateNovember 29, 2021
Last NPPES UpdateJanuary 9, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 9, 2026
✔ NPI 1710645544 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 2021039559
425 E STATE ST, Jacksonville, IL 62650
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Other Providers at the Same Location NPPES 3

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

JADE YOUNG
Community Health Worker
425 E STATE ST
JACKSONVILLE, IL 62650
Morgan County (217) 670-5590
ANNETTE E HUDDLESTON MSW, CADC
Community Health Worker
425 E STATE ST
JACKSONVILLE, IL 62650
Morgan County (217) 408-1195
BETHANY ALLEN
Community Health Worker
425 E STATE ST
JACKSONVILLE, IL 62650
Morgan County (217) 899-1817

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 Andrea Moore's NPI number?

The NPI number for Andrea Moore is 1710645544. It was assigned to this individual provider in the NPPES registry on November 29, 2021.

Where is Andrea Moore located?

Andrea Moore practices at 425 E State St, Jacksonville, IL 62650. The listed phone number is (217) 408-1195.

What is Andrea Moore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Andrea Moore was last updated on January 9, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.