Individual
MARKETTA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 485-6785
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 485-6785
Taxonomy
Speciality
Code
Description
License number
State
163WX0003X
Inpatient Obstetric Registered Nurse
Primary
1-126042
AL
Other
Enumeration date
09/03/2014
Last updated
09/03/2014
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