Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Traci Moore, APRN, FNP-C

Individual provider Family Medicine Physician · NPI 1225570005

Traci Moore, APRN, FNP-C is a Nurse Practitioner in Kingman, Arizona. Graduated from University of Arizona College of Medicine - Phoenix in 2020, 6 years ago. Practices with Lakeside Heart and Vascular Center PLLC, a 19-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
6
Trained at
University of Arizona College of Medicine - Phoenix
Licensed in
AZ
In the registry since
2016
Specialties on file
4
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

3931 N Stockton Hill Rd
Kingman, AZ 86409-2426
Phone: (928) 385-7100
Fax: (855) 538-3114
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 315038 (AZ)
Family Medicine Physician Taxonomy 207Q00000X · Licence RNP315038 (AZ)
Psychiatric/Mental Health Registered Nurse Taxonomy 163WP0808X · Licence RN186954 (AZ)
Registered Nurse Taxonomy 163W00000X · Licence RN186954 (AZ)

Record details

NPI number1225570005
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN , FNP-C
Sole proprietorNo
NPI enumeratedNovember 10, 2016
Last updated in NPPESDecember 4, 2025
Certification dateDecember 4, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF ARIZONA COLLEGE OF MEDICINE - PHOENIX
Graduated 2020 (6 years in practice)
Group practice Lakeside Heart And Vascular Center Pllc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Kingman