Individual
MARIAN TERESA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3025 KATE BOND RD, BARTLETT, TN 38133-4004
(901) 259-5569
Mailing address
3025 KATE BOND RD, BARTLETT, TN 38133-4004
(901) 259-5569
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
RN0000073630
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902913692
KASHIF LATIF, MD
TN
Enumeration date
03/14/2019
Last updated
06/11/2019
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