Provider Demographics
NPI:1407869175
Name:MOORE, ANN A (MIDWIFE)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:A
Last Name:MOORE
Suffix:
Gender:F
Credentials:MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 E MARION ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2758
Mailing Address - Country:US
Mailing Address - Phone:717-397-3066
Mailing Address - Fax:
Practice Address - Street 1:31 S LIME ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-3564
Practice Address - Country:US
Practice Address - Phone:717-299-2891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW008594L367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife