Individual
MRS. WIETSKE WILLEMSMA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
3020 14TH ST NW, WASHINGTON, DC 20009-6865
(202) 745-4300
(202) 745-5907
Mailing address
12548 MOUNTAIN RD, LOVETTSVILLE, VA 20180-2609
(703) 554-4527
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN966736
DC
Other
Enumeration date
12/15/2006
Last updated
09/06/2011
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