Individual
MS. JEANNE I. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3137 SONIA TRL, ELLICOTT CITY, MD 21043-3276
(410) 465-2048
Mailing address
3137 SONIA TRL, ELLICOTT CITY, MD 21043-3276
(410) 465-2048
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R102368
MD
Other
Enumeration date
06/23/2011
Last updated
06/23/2011
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