Individual
JODIE H MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
415 6TH ST, BOSWELL, OK 74727-7472
(580) 566-2530
(580) 566-2533
Mailing address
415 6TH ST, BOSWELL, OK 74727
(580) 566-2530
(580) 566-2533
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
86293
OK
Other
Enumeration date
06/07/2019
Last updated
03/25/2022
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