Individual
MISS JACKIE KAYE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
100 BLYTHEWOOD DR, COLUMBIA, TN 38401-4828
(931) 388-5757
(931) 381-7901
Mailing address
100 BLYTHEWOOD DR, COLUMBIA, TN 38401-4828
(931) 388-5757
(931) 381-7901
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN0000141209
TN
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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