Individual
MS. KELITA LESHEA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE
Contact information
Practice address
1320 N MICHIGAN AVE, SAGINAW, MI 48602
(989) 401-9015
(989) 401-9018
Mailing address
2912 STATE ST, SAGINAW, MI 48602-3743
(989) 529-0027
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703096951
MI
Other
Enumeration date
06/23/2018
Last updated
07/05/2018
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