Individual
MARY ELIZABETH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-AC/PC
Contact information
Practice address
1001 JOHNSON FY RD NE, ATLANTA, GA 30342-1605
(404) 785-5437
Mailing address
1880 FAIRWAY CIR NE, BROOKHAVEN, GA 30319-3821
(678) 234-2461
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN250218
GA
Other
Enumeration date
09/18/2020
Last updated
03/04/2022
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