Individual
SHAYNTELLE KIYOKO MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP-PC
Contact information
Practice address
3300 GAITHER RD, BALTIMORE, MD 21244-2916
(410) 922-2100
Mailing address
3300 GAITHER RD, BALTIMORE, MD 21244-2916
(410) 922-2100
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R206431
MD
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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