Individual
MRS. LATORYA DELOIS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, AGPCNP-BC
Contact information
Practice address
514 N BRIGHTLEAF BLVD STE 1100, SMITHFIELD, NC 27577
(919) 989-2192
(919) 934-0006
Mailing address
514 N BRIGHTLEAF BLVD STE 1100, SMITHFIELD, NC 27577-4487
(919) 989-2192
(919) 934-0006
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5010083
NC
Other
Enumeration date
12/09/2017
Last updated
12/01/2019
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