Individual
KATIE SCIANNA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
4210 LINCOLN RD, HATTIESBURG, MS 39402-3093
(601) 261-3500
(601) 261-3583
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 261-3500
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
903811
MS
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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