Individual
LATRICE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
19450 DEERFIELD AVE STE 325, LEESBURG, VA 20176-8503
(571) 252-8119
Mailing address
41049 INDIGO PL, LEESBURG, VA 20175-4825
(703) 297-2685
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024182341
VA
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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