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Individual

DIANE A MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
475 KILVERT ST, WARWICK, RI 02886-1392
(401) 871-1026
Mailing address
475 KILVERT ST, WARWICK, RI 02886-1392
(401) 871-1026

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
NPP00142-T
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1467697169
NPI
RI
Enumeration date
12/09/2008
Last updated
07/23/2015
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