Individual
MRS. KATHLEEN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CDE
Contact information
Practice address
500 FOOTHILL BLVD, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
(801) 584-1576
Mailing address
500 FOOTHILL BLVD, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
(801) 584-1576
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
220464-3102
UT
Other
Enumeration date
01/09/2013
Last updated
01/09/2013
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