Individual
CHRISTI L MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5104 N 67TH AVE, GLENDALE, AZ 85301-6541
(602) 899-4404
Mailing address
PO BOX 41638, PHOENIX, AZ 85080-1638
(602) 899-4404
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1967
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377897
—
AZ
Enumeration date
07/24/2006
Last updated
08/21/2018
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