Individual
TRAKENA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 N JACKSON ST, AMERICUS, GA 31709-3015
(229) 931-2485
Mailing address
PO BOX 532, SASSER, GA 39885-0532
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN235919
GA
Other
Enumeration date
06/30/2014
Last updated
06/30/2014
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