Individual
DANIELLE LEANDREA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1491 HIDDEN HILLS PKWY, STONE MOUNTAIN, GA 30088-3120
(703) 861-9358
(770) 695-0282
Mailing address
1491 HIDDEN HILLS PKWY, STONE MOUNTAIN, GA 30088-3120
(703) 861-9358
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN072524
GA
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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