Individual
ALFREA TIESE RILEY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6848 MONTANA ST, CAMP LEJEUNE, NC 28547-2558
(504) 621-6124
Mailing address
6848 MONTANA ST, CAMP LEJEUNE, NC 28547-2558
(504) 621-6124
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
285208
NC
Other
Enumeration date
01/11/2018
Last updated
01/11/2018
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