Individual
CHARLOTTE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
13655 RIVERPORT DR, MARYLAND HTS, MO 63043-4812
(314) 592-7000
Mailing address
22 BRIXWORTH CT, BLACK JACK, MO 63033-7438
(314) 393-6693
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2015009949
MO
Other
Enumeration date
03/12/2015
Last updated
01/27/2022
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