Individual
SHELBY B MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
28315 S FROST RD, LIVINGSTON, LA 70754-2612
(225) 283-1356
(225) 686-2962
Mailing address
PO BOX 395, CLINTON, LA 70722-0395
(225) 683-5292
(225) 683-3411
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
224079
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
224079
FNP LICENSE
LA
Enumeration date
01/28/2022
Last updated
01/28/2022
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