Individual
MS. NIDRA SUWAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
4135 N COLGATE CIR, MILWAUKEE, WI 53222-1735
(414) 527-1002
Mailing address
4135 N COLGATE CIR, MILWAUKEE, WI 53222-1735
(414) 527-1002
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
153190-030
WI
Other
Enumeration date
11/18/2008
Last updated
11/18/2008
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