Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Andrea Diane Moore, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1710645544

Andrea Diane Moore, FNP-BC is a Family Nurse Practitioner in Jacksonville, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2021
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

425 E State St
Jacksonville, IL 62650-2125
Phone: (217) 408-1195
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 2021039559 (IL)

Record details

NPI number1710645544
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorYes
NPI enumeratedNovember 29, 2021
Last updated in NPPESJanuary 9, 2026
Certification dateJanuary 9, 2026

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