TRACY RENE MOORE LPNCSFA NPI 1033982053

NPI Information

  • NPI: 1033982053
  • Provider Name: TRACY RENE MOORE, LPN,CSFA
  • Classification: Licensed Practical Nurse - 164W00000X
  • Entity Type: Individual
  • Address: 1404 CROSS ST
    SHILOH, IL
    ZIP 62269
  • Phone: (618) 607-1000

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NPI Details

Tracy Rene Moore, LPN,CSFA is a licensed practical nurse in Shiloh, IL. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. Tracy Rene Moore, LPN,CSFA NPI is 1033982053. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1404 CROSS ST
SHILOH, IL
ZIP 62269-988
Phone: (618) 607-1000

The enumeration date for this NPI number is 11/1/2023 and was last updated on 11/1/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1164W00000XLicensed Practical Nurse043116387ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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