Individual
MRS. LISA MARCELLA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
409 SE GREENVILLE AVE, WINCHESTER, IN 47394-9464
(765) 584-0480
Mailing address
409 SE GREENVILLE AVE, WINCHESTER, IN 47394-9464
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71008271A
IN
363LF0000X
Family Nurse Practitioner
APRN.CNP.022576
OH
Other
Enumeration date
03/22/2018
Last updated
07/26/2022
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