Individual
MARISA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
915 6TH AVE STE 100, TACOMA, WA 98405-4682
(253) 403-7277
Mailing address
325 POSTWOOD DR, FAYETTEVILLE, GA 30215-7604
(678) 873-0958
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN278019
GA
Other
Enumeration date
04/13/2020
Last updated
11/30/2022
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