Individual
CHANTZ MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN- CNP
Contact information
Practice address
700 E MARSHALL AVE, LONGVIEW, TX 75601-5580
(903) 315-2000
Mailing address
700 E MARSHALL AVE, LONGVIEW, TX 75601-5580
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1123730
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
1123730
TX
Other
Enumeration date
07/05/2023
Last updated
08/16/2023
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