Individual
MRS. KATHY ANN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1310 THOMAS LANGSTON RD, UNIT 6, WINTERVILLE, NC 28590-8364
(252) 544-1855
Mailing address
1310 THOMAS LANGSTON RD, UNIT 6, WINTERVILLE, NC 28590-8364
(252) 544-1855
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
70547
NC
Other
Enumeration date
12/30/2012
Last updated
12/30/2012
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