Individual
DESARAYE MICHELLE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
69 MAZE PLZ, ELIZABETH, WV 26143-5127
(304) 598-6084
Mailing address
186 COFER ST, WASHINGTON, WV 26181-8209
(304) 532-1818
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
113065
WV
Other
Enumeration date
01/23/2025
Last updated
01/23/2025
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