Individual
MRS. EMBER SHYAMALA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
(603) 650-5402
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
077379-23
NH
363LA2100X
Acute Care Nurse Practitioner
201708281NP-PP
OR
Other
Enumeration date
10/05/2017
Last updated
06/27/2019
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