Individual
MS. TRENITA LASHAWN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
200 W RAILROAD ST, LONG BEACH, MS 39560-4517
(228) 864-0622
(228) 864-7958
Mailing address
PO BOX 869, 200 W RAILROAD STREET, LONG BEACH, MS 39560-0869
(228) 864-0622
(228) 864-7958
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R862256
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0620608060
—
MS
Enumeration date
05/29/2007
Last updated
01/21/2021
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