Individual
RAVEN ORGERON MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, RN
Contact information
Practice address
1333 RIDGE WAY DR, MANDEVILLE, LA 70471-7461
(225) 328-1665
Mailing address
1333 RIDGE WAY DR, MANDEVILLE, LA 70471-7461
(225) 328-1665
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
RN110443
LA
363LF0000X
Family Nurse Practitioner
Primary
234256
LA
363LF0000X
Family Nurse Practitioner
RN110443
LA
Other
Enumeration date
08/14/2023
Last updated
01/27/2024
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