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Individual
MRS. SHAREA N MOORE
Active
Individual
MRS. SHAREA N MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN207060
GA
363L00000X
Nurse Practitioner
F0912305
GA
363LF0000X
Family Nurse Practitioner
Primary
F0912305
GA
363LF0000X
Family Nurse Practitioner
RN207060
GA
Other
Enumeration date
09/25/2012
Last updated
04/27/2020
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