Individual
KATHRYN LEE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4500 N LEWIS AVE, SIOUX FALLS, SD 57104-7111
(605) 322-6368
Mailing address
4500 N LEWIS AVE, SIOUX FALLS, SD 57104-7111
(605) 322-6368
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
CP001926
SD
Other
Enumeration date
12/24/2020
Last updated
12/24/2020
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