Individual
AVIS MARIE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
300 S 6TH ST, GOV. CENTER A-14, MINNEAPOLIS, MN 55487-0999
(612) 596-1223
Mailing address
300 S 6TH ST, GOV. CENTER A-14, MINNEAPOLIS, MN 55487-0999
(612) 596-1223
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R121109-2
MN
Other
Enumeration date
11/28/2011
Last updated
11/28/2011
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