Most Relevant Information
Provider Data
| NPI Number: | 1003453218 |
| Provider Name: | KATHLEEN MOORE CNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | APRN.CNP.024429 |
Most Important Dates
| Enumeration Date: | 12/06/2019 |
| Last Updated: | 09/15/2021 |
Provider Practice Location
1320 MERCY DR NW
CANTON
OH
447082614
Practice Location Phone/Fax
| Phone: | 3305884676 |
| Fax: |
Provider Mailing Location
1330 MERCY DR NW STE 101
CANTON
OH
447082624
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |