Individual
LAVERNE MICHELLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1200 S 1ST ST, CORSICANA, TX 75110-8200
(903) 229-8203
(888) 777-4809
Mailing address
1200 S 1ST ST, CORSICANA, TX 75110-8200
(903) 229-8203
(888) 777-4809
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
197274
TX
Other
Enumeration date
07/01/2010
Last updated
07/01/2010
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