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Individual
NICOLE M MOORE
Active
Individual
NICOLE M MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041390820
IL
363LF0000X
Family Nurse Practitioner
Primary
209-014814
IL
Other
Enumeration date
07/19/2016
Last updated
03/14/2022
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