Individual
DONNA D MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4105 FORT HENRY DR, SUITE 207, KINGSPORT, TN 37663-2240
(423) 239-5833
(423) 239-9789
Mailing address
4105 FORT HENRY DR, SUITE 207, KINGSPORT, TN 37663-2240
(423) 239-5833
(423) 239-9789
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
21382
TN
Other
Enumeration date
11/03/2006
Last updated
07/08/2007
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