Individual
MS. CHERI LYN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
3500 INTERSTATE 30 AT MOTLEY DR., MESQUITE, TX 75150
(972) 698-2051
Mailing address
400 VALVERDE CT, SOUTHLAKE, TX 76092-5935
(817) 481-7544
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
235104
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002291501
—
TX
05
—
090153005
—
TX
Enumeration date
08/10/2005
Last updated
05/18/2008
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