Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MISS HOLLY SUZANNE MOORE, MSOTR/L
Active Sole ProprietorMISS HOLLY SUZANNE MOORE, MSOTR/L is a Skilled Nursing Facility healthcare provider located in CROSSVILLE, Illinois. NPI 1255648390 is currently active in the NPPES registry. Verify at CMS.
Skilled Nursing Facility · CROSSVILLE, IL
Registration Details
- NPI Number
- 1255648390
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 10, 2010 (15.898265111006 yrs)
- Last Updated
- Sep 10, 2010
- Licenses
-
31004566A (IN)056.008560 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
202 WEST DAVENPORT STREETCROSSVILLE, IL, 62827Browse IL providers · Browse ZIP 62827
- Phone
- 6189284801
- Primary Specialty
-
Skilled Nursing Facility
314000000X
- Additional Specialty
- Skilled Nursing Facility
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.