Individual
MICHELLE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
113 ANGIS LN, LEWISVILLE, TX 75056-5835
(303) 204-8578
Mailing address
113 ANGIS LN, LEWISVILLE, TX 75056-5835
(303) 204-8578
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
167932
CO
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
1129005
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
27520781
—
CO
Enumeration date
02/24/2009
Last updated
07/11/2024
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