Individual
MALLORY BUTLER MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
101 SIVLEY RD SW, HUNTSVILLE, AL 35801-4470
(256) 265-1000
Mailing address
7832 HORSESHOE TRL SE, HUNTSVILLE, AL 35802-3218
(256) 457-8547
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-149936
AL
Other
Enumeration date
05/11/2021
Last updated
05/11/2021
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