Individual
ALICIA SHANDRELL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2205 E 70TH ST, SHREVEPORT, LA 71105-5321
(318) 797-1585
Mailing address
5610 BUNCOMBE RD APT 1308, SHREVEPORT, LA 71129-3623
(318) 302-1685
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
221828
LA
Other
Enumeration date
10/13/2021
Last updated
10/13/2021
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