Individual
REBECCA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD, CSSD
Contact information
Practice address
WOMACK ARMY MEDICAL CENTER 2817 REILLY ROAD, FORT BRAGG, NC 28310-0001
(225) 954-8013
Mailing address
5145 500TH ST SE, IOWA CITY, IA 52240-8329
Taxonomy
Speciality
Code
Description
License number
State
133VN1501X
Sports Dietetics Nutrition Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
075BB3202
DRIVER LICENSE
IA
Enumeration date
09/01/2021
Last updated
09/02/2021
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