Individual
NINA RAE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
222 PHILADELPHIA PIKE, WILMINGTON, DE 19809-3166
(646) 406-7042
Mailing address
PO BOX 3034, CHERRY HILL, NJ 08034-0274
(646) 406-7042
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
26NR16371200
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
L8-0010539
DE
Other
Enumeration date
11/27/2023
Last updated
12/04/2023
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