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Individual

MS. HEATHER MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
2675 N DECATUR RD, SUITE301, DECATUR, GA 30033-6131
(404) 294-0472
Mailing address
2675 N DECATUR RD, SUITE 301, DECATUR, GA 30033-6131
(404) 294-0472

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
RN169917 CNM
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CNM0204
CNM LICENSE
GA
Enumeration date
11/18/2010
Last updated
06/23/2015
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