Provider Demographics
NPI:1669251906
Name:MOORE, NORA COLLEEN (RN)
Entity type:Individual
Prefix:MS
First Name:NORA
Middle Name:COLLEEN
Last Name:MOORE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:NORA
Other - Middle Name:COLLEEN
Other - Last Name:RUST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2123 STOPPER DR
Mailing Address - Street 2:
Mailing Address - City:MONTOURSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17754-9697
Mailing Address - Country:US
Mailing Address - Phone:570-980-4643
Mailing Address - Fax:
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-9800
Practice Address - Country:US
Practice Address - Phone:570-271-6763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN618653163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine