Individual
MRS. SANDRA JEANNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
107 W BROADWAY, PATHWAY'S BEHAVIORAL HEALTH CARE, ELDORADO SPRINGS, MO 64744
(417) 876-5314
(417) 876-5328
Mailing address
1800 COMMUNITY DRIVE, MIDWEST HEALTH CARE MANAGEMENT INC, CLINTON, MO 68735
(660) 885-8131
(660) 885-4785
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
042689
MO
Other
Enumeration date
11/02/2010
Last updated
11/02/2010
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