Provider Demographics
NPI:1326029273
Name:MOORE, DEBORAH IRENE (ARNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:IRENE
Last Name:MOORE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:MOORE
Other - Last Name:KUZMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:138 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-2512
Mailing Address - Country:US
Mailing Address - Phone:603-663-7030
Mailing Address - Fax:603-663-7039
Practice Address - Street 1:138 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-2512
Practice Address - Country:US
Practice Address - Phone:603-663-7030
Practice Address - Fax:603-663-7039
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH044636-23-05363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH23YP04736NH01OtherANTHEM ACES PIN
NHP00118051OtherRR MEDICARE PIN
NH044363OtherTUFTS PIN
NH30102YOtherANTHEM REFERRING RAN
NH30342539Medicaid
NH5796011OtherCIGNA PIN
NHS67113OtherHPHC PIN
NH23YP04736NH01OtherANTHEM ACES PIN
NH30102YOtherANTHEM REFERRING RAN