Individual
LAURA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1465 LAKELAND DR, JACKSON, MS 39216-4719
(769) 777-1080
Mailing address
1465 LAKELAND DR, JACKSON, MS 39216-4719
(769) 777-1080
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R877261
MS
Other
Enumeration date
05/28/2015
Last updated
05/28/2015
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