Individual
MRS. KISUK K MOORE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
401 CARPENTER RD, FORT MYER, VA 22211-1009
(703) 696-3629
Mailing address
401 CARPENTER RD, FORT MYER, VA 22211-1009
(703) 696-3629
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001120941
VA
Other
Enumeration date
02/14/2006
Last updated
07/08/2007
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