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

Karley Brooke Moore

Individual provider Family Nurse Practitioner · NPI 1114520491

Karley Brooke Moore is a Nurse Practitioner in Manila, Arkansas. Qualified in 2020, 6 years ago. Practices with T W Wagner Inc, a 9-clinician group and accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
6
Licensed in
AR
In the registry since
2020

Practice location Address checks out

3644 W State Highway 18
Manila, AR 72442-8049
Phone: (708) 561-3300
Fax: (870) 561-3307
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 212805 (AR)

Record details

NPI number1114520491
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 18, 2020
Last updated in NPPESJanuary 16, 2024
Certification dateJanuary 16, 2024
Mailing address624 Lanes Way, Manila, AR 72442-9136

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice T W Wagner Inc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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