Individual
JESSICA MICHELLE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8400 CROWN HILL BLVD, SAN ANTONIO, TX 78209
(210) 860-0532
Mailing address
586 LAUREL LN, NEW BRAUNFELS, TX 78130-6150
(830) 387-1295
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
342281
TX
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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