Individual
BETTY KAREN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5515 CLEVELAND AVE, STEVENSVILLE, MI 49127-9670
(269) 429-9644
(269) 429-4002
Mailing address
5515 CLEVELAND AVE, STEVENSVILLE, MI 49127-9670
(269) 429-9644
(269) 429-4002
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704282019
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366746257
—
MI
Enumeration date
01/06/2011
Last updated
02/25/2020
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