Individual
MS. SHAMAINE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2701 W FAIRMOUNT AVE, MILWAUKEE, WI 53209-5523
(414) 426-4535
Mailing address
4971 N 27TH ST, MILWAUKEE, WI 53209-5512
(414) 204-5755
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
0020756
WI
Other
Enumeration date
12/11/2025
Last updated
12/11/2025
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