Shannon Denise Moore, LPN
Licensed Practical Nurse in Hillsboro, IL. Individual provider (NPI-1).
NPI number1861692022
StatusActive
Last updated in NPPESJul 24, 2007
Details
- NPI
- 1861692022
- Entity type
- Individual (NPI-1)
- Name
- Shannon Denise Moore
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 24, 2007
- Last updated
- Jul 24, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 43074378 | IL | Yes |
Practice location
11191 Illinois Route 185Hillsboro, IL 62049-2664
Phone 217-532-2001 · Fax 217-532-6361
Mailing address
11191 Illinois Route 185Hillsboro, IL 62049-2664
Phone 217-532-2001 · Fax 217-532-6361
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