Individual
SANDRA LEE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP, APRN
Contact information
Practice address
609 W MAPLE AVE, SPRINGDALE, AR 72764-5335
(479) 757-1260
Mailing address
8140 OZARK RIDGE DR, ROGERS, AR 72756-6325
(479) 387-5225
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
124033
AR
Other
Enumeration date
07/03/2020
Last updated
10/12/2020
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