Individual
MS. BERTHA JEAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
236 MIDWAY, PRESCOTT, AZ 86305-5051
(650) 799-1017
Mailing address
236 MIDWAY, PRESCOTT, AZ 86305-5051
(650) 799-1017
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
RN070305
AZ
Other
Enumeration date
02/02/2022
Last updated
02/02/2022
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