Individual
JEANIE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13101 LOMAS BLVD NE UNIT 50365, ALBUQUERQUE, NM 87123-1492
(916) 806-1505
Mailing address
13101 LOMAS BLVD NE UNIT 50365, ALBUQUERQUE, NM 87123-1492
(916) 806-1505
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
838921
CA
Other
Enumeration date
10/30/2025
Last updated
10/30/2025
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