Individual
LISA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12055 W 2ND PL, LAKEWOOD, CO 80228-1506
(303) 432-5409
Mailing address
17312 LINDON DR, PARKER, CO 80134-7536
(303) 489-1553
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0162078
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2807127
—
CO
Enumeration date
07/17/2014
Last updated
07/17/2014
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