Organization
CJM ELDERHEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDIE ROSS-MOORE NP (NURSE PRACTICIONER)
(314) 324-3401
Entity
Organization
Contact information
Practice address
415 GLENMEADOW DR, BALLWIN, MO 63011-3466
(636) 566-8155
Mailing address
415 GLENMEADOW DR, BALLWIN, MO 63011-3466
(636) 566-8155
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
088713
MO
Other
Enumeration date
01/13/2010
Last updated
06/24/2010
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