Individual
EBONY NICOLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1601 LUBBOCK DR, COPPERAS COVE, TX 76522-2186
(512) 350-6235
Mailing address
1601 LUBBOCK DR, COPPERAS COVE, TX 76522-2186
(512) 350-6235
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
300006
TX
Other
Enumeration date
02/16/2018
Last updated
02/16/2018
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