Individual
CANDY JO MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 S EL CAMINO REAL, SAN MATEO, CA 94402-1704
(844) 670-2273
Mailing address
110 E 4TH ST, EVART, MI 49631-9556
(231) 250-4797
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
470429866
MI
163WC0400X
Case Management Registered Nurse
Primary
470429866
MI
Other
Enumeration date
08/25/2020
Last updated
01/14/2026
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