Individual
LIZA PRUDENTE MOORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
LEE STREET GROUND FLOOR, CHARLOTTESVILLE, VA 22908-0001
(434) 982-3817
(434) 243-2625
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
(434) 295-1000
(434) 972-4266
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024166120
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497974240
—
VA
Enumeration date
04/24/2007
Last updated
06/24/2009
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