Individual
CHARLI LEANN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 766-3600
Mailing address
2 HALLISON CIR, MILTON, WV 25541-1208
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
113757
WV
Other
Enumeration date
06/18/2026
Last updated
06/18/2026
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