Individual
SANNIA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
401 N BROADWAY ST, SUITE 1358, BALTIMORE, MD 21287-0019
(410) 614-3975
Mailing address
17 WICKHAM CT, REISTERSTOWN, MD 21136-3092
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R169636
MD
Other
Enumeration date
09/23/2014
Last updated
09/23/2014
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