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

Nicole Moore, NP

Individual provider Nurse Practitioner · NPI 1558731075

Nicole Moore, NP is a Nurse Practitioner in Traverse City, Michigan. Qualified in 2015, 11 years ago. Practices with Genesis Health System, a 262-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
11
Licensed in
MI
In the registry since
2015
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

1014 Sixth St Ste 101
Traverse City, MI 49684-2398
Phone: (231) 421-6921
Fax: (231) 421-7852
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 4704230526 (MI)

Record details

NPI number1558731075
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorYes
NPI enumeratedSeptember 26, 2015
Last updated in NPPESSeptember 26, 2015
Mailing address1014 Sixth St Ste 101, Traverse City, MI 49684-2398

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Genesis Health System — 262 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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