Individual
RAQUEL GRACE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1423 N JEFFERSON AVE, B100, SPRINGFIELD, MO 65802-1917
(417) 269-8825
Mailing address
3800 S NATIONAL AVE, STE 540, SPRINGFIELD, MO 65807-5209
(417) 269-8759
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2016008615
MO
Other
Enumeration date
03/08/2016
Last updated
03/23/2016
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