Individual
ELIZABETH MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM LM
Contact information
Practice address
11029 QUAKER VALLEY RD, CAZENOVIA, WI 53924-8214
(608) 415-7813
Mailing address
11029 QUAKER VALLEY RD, P.O. BOX 235, CAZENOVIA, WI 53924-8214
(608) 415-7813
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
154-49
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15070010
THE NORTH AMERICAN REGISTRY OF MIDWIVES
—
01
—
154-49
STATE OF WISCONSIN LICENSE
WI
Enumeration date
09/17/2016
Last updated
09/17/2016
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