Individual
MRS. DEBRA M MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LMNT
Contact information
Practice address
4600 38TH ST, COLUMBUS COMMUNITY HOSPITAL, COLUMBUS, NE 68601-1664
(402) 562-4460
(402) 562-3378
Mailing address
3170 38TH AVE, COLUMBUS, NE 68601-4476
(402) 563-4022
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
328
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81052
CCH BCBS MNT PROV
NE
Enumeration date
12/27/2006
Last updated
07/08/2007
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