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Individual

MS. MARY ELIZABETH MOAT

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
RN, NP

Contact information

Practice address
ZABLOCKI VA MEDICAL CENTER, 5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 385-2000
Mailing address
1841 W HALSEY AVE, MILWAUKEE, WI 53221-2842
(414) 281-3896

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
49641
WI

Other

Enumeration date
07/13/2005
Last updated
07/08/2007
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