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

Kimberly Moore, LAT

Individual provider Athletic Trainer · NPI 1477301604

Kimberly Moore, LAT is an Athletic Trainer in Green Bay, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2024
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

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Practice location Address checks out

1970 S Ridge Rd
Green Bay, WI 54304-4125
Phone: (920) 430-4888
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 3155-39 (WI)

Record details

NPI number1477301604
Entity typeIndividual (Type 1)
GenderFemale
Credentials LAT
Sole proprietorYes
NPI enumeratedMay 13, 2024
Last updated in NPPESMay 13, 2024
Certification dateMay 12, 2024
Mailing address310 Madison Way Apt 5, Shawano, WI 54166-3872

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