Individual
MELISSA ROSE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, CNP, PMHNP-BC
Contact information
Practice address
1111 11TH ST NW, ALBUQUERQUE, NM 87104-2105
(810) 923-6043
(505) 727-4505
Mailing address
1111 11TH ST NW, ALBUQUERQUE, NM 87104-2105
(810) 923-6043
(505) 727-4505
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704257647
MI
163W00000X
Registered Nurse
RN-78727
NM
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
77534
NM
367A00000X
Advanced Practice Midwife
670
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31902243
—
NM
Enumeration date
02/20/2014
Last updated
12/30/2024
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