Individual
DARIELLE B MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1533 MARSHALL ST, SHREVEPORT, LA 71101-3941
(318) 626-5597
Mailing address
1533 MARSHALL ST, SHREVEPORT, LA 71101-3941
(318) 626-5597
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
30002761
LA
Other
Enumeration date
04/25/2025
Last updated
04/25/2025
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