Individual
JANESSA CYNTHIA LUCILLE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCPT
Contact information
Practice address
7962 RESURRECTION DR, ANCHORAGE, AK 99504-4729
(907) 205-9435
Mailing address
7962 RESURRECTION DR, ANCHORAGE, AK 99504-4729
(907) 205-9435
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
945987
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
945987
NATION CENTER OF COMPETENCY
AK
Enumeration date
09/10/2019
Last updated
09/10/2019
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