Individual
CHARLENE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5676 BROADVIEW RD, APT 523, CLEVELAND, OH 44134-1635
(216) 551-2845
Mailing address
13309 OAKVIEW BLVD, GARFIELD HTS, OH 44125-3951
(216) 266-7318
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
520052
OH
164W00000X
Licensed Practical Nurse
PN152204
OH
Other
Enumeration date
02/11/2014
Last updated
03/19/2024
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