Provider Demographics
NPI:1467555672
Name:MOORE, MARIANNE FRANCES (APRN, CNM)
Entity Type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:FRANCES
Last Name:MOORE
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:690 S LOOP 336 W
Mailing Address - Street 2:STE 200
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3320
Mailing Address - Country:US
Mailing Address - Phone:936-525-3600
Mailing Address - Fax:
Practice Address - Street 1:690 S LOOP 336 W STE 200
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3320
Practice Address - Country:US
Practice Address - Phone:936-525-3600
Practice Address - Fax:936-525-3624
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP115758367A00000X
CO4473367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife