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

Crystal Moore

Individual provider Contractor · NPI 1164170189

Crystal Moore is a Contractor in Milwaukee, Wisconsin. Registered with an NPI since 2022.

In the registry since
2022
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Practice location Address checks out

2115 W Roosevelt Dr
Milwaukee, WI 53209-6323
Phone: (414) 207-0551
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Contractor (primary) Taxonomy 171W00000X

Record details

NPI number1164170189
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 17, 2022
Last updated in NPPESMarch 17, 2022
Certification dateMarch 17, 2022
Mailing address2115 W Roosevelt Dr, Milwaukee, WI 53209-6323

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