Individual
MARY JANE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
700 19TH ST S, BIRMINGHAM, AL 35233-1927
(205) 933-8101
Mailing address
4405 S SHADES CREST RD, BESSEMER, AL 35022
(205) 481-3566
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-026106
AL
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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