Individual
RHONDA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1696 STATE RD 122, PREWITT, NM 87045
(505) 290-0814
Mailing address
PO BOX 1685, GRANTS, NM 87020-1685
(505) 290-0814
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
R54662
NM
253Z00000X
In Home Supportive Care Agency
R54662
NM
374U00000X
Home Health Aide
R54662
NM
Other
Enumeration date
07/01/2020
Last updated
08/28/2023
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