Individual
SUSAN M MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
111 N 175TH ST, OMAHA, NE 68118-3579
(402) 778-5220
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
(402) 559-6195
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
110792
NE
Other
Enumeration date
08/07/2006
Last updated
05/12/2016
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