Individual
MICHAEL S MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
14301 N 87TH ST STE 314, SCOTTSDALE, AZ 85260-3691
(623) 455-6564
Mailing address
1822 S 39TH ST UNIT 121, MESA, AZ 85206-3831
(815) 575-4073
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
258844
AZ
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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