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Individual

MICHAEL HOWARD MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
10820 PARKSIDE DR, KNOXVILLE, TN 37934-1956
(865) 218-7011
Mailing address
501 20TH ST STE 606, KNOXVILLE, TN 37916-1863
(865) 331-2278

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
216342
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
32660
TN

Other

Enumeration date
06/15/2022
Last updated
10/05/2022
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