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

Miss. Holly Suzanne Moore, MSOTR/L

Individual provider Skilled Nursing Facility · NPI 1255648390

Miss. Holly Suzanne Moore, MSOTR/L is a Skilled Nursing Facility in Crossville, Illinois. Practices as a sole proprietor. Licensed in Illinois and Indiana.

Licensed in
IL, IN
In the registry since
2010
Specialties on file
2

Practice location Address checks out

202 W Davenport St
Crossville, IL 62827
Phone: (618) 928-4801
Show map & directions

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

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X · Licence 056.008560 (IL)
Skilled Nursing Facility Taxonomy 314000000X · Licence 31004566A (IN)

Record details

NPI number1255648390
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSOTR/L
Sole proprietorYes
NPI enumeratedSeptember 10, 2010
Last updated in NPPESSeptember 10, 2010