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Individual

DEIDRA M MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
4615 GOVERNMENT ST, BUILDING 2, BATON ROUGE, LA 70806-5820
(225) 925-1906
(225) 925-1972
Mailing address
4615 GOVERNMENT ST, BUILDING 2, BATON ROUGE, LA 70806-5820
(225) 925-1906
(225) 925-1972

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN065607
LA

Other

Enumeration date
03/07/2007
Last updated
07/08/2007
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