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Individual

MRS. MICHELLE JEAN MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
95 LOCUST AVENUE 1ST FLOOR ONCOLOGY, STROOCK BUILDING, DANBURY, CT 06810
(203) 739-7029
Mailing address
12 EMPIRE LN, BETHEL, CT 06801-3069
(203) 994-6720

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8254
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8254
LICENSE
CT
Enumeration date
07/20/2019
Last updated
04/18/2021
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