Individual
MARIAN FRANCES IRIS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CNM
Contact information
Practice address
3260 KERNER BLVD, SAN RAFAEL, CA 94901-4861
(415) 473-4117
(415) 473-5005
Mailing address
4545 TWIG AVE, SEBASTOPOL, CA 95472-5700
(707) 829-7880
(415) 473-5005
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
Primary
377751
CA
367A00000X
Advanced Practice Midwife
705
CA
Other
Enumeration date
11/01/2006
Last updated
12/17/2008
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