IndividualActive
Gaston Moore, LPN
NPI 1760717797 · Licensed Vocational Nurse · Phoenix, AZ
Provider details
- NPI number
- 1760717797
- Entity type
- Individual
- Primary specialty
- Licensed Vocational NurseNursing Service Providers
- Credential
- LPN
- Sex
- Male
- Sole proprietor
- Yes
- License
- LP039366 (AZ)
Specialties & taxonomies
Nursing Service Providers
Practice location
1702 W Tuckey Ln
Phoenix, AZ 85015-1715
Phone: (602) 518-5910
Approximate (ZIP-level) locationGet directions
Mailing address
1702 W Tuckey Ln
Phoenix, AZ 85015-1715
Registry dates
- Enumerated
- 2009-10-08
- Last updated
- 2009-10-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.