Individual
MS. LISA ANN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
360 DOGWOOD DR, BUELLTON, CA 93427-6809
(805) 453-4218
Mailing address
360 DOGWOOD DR, BUELLTON, CA 93427-6809
(805) 453-4218
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
95031277
CA
Other
Enumeration date
06/02/2026
Last updated
06/02/2026
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