Individual
MICHELLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3030 CHESTNUT ST, LEBANON, PA 17042-2518
(717) 270-8000
Mailing address
3030 CHESTNUT ST, LEBANON, PA 17042-2518
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN314526
PA
Other
Enumeration date
04/30/2021
Last updated
04/30/2021
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