Individual
JACLYN M MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
777 37TH ST, SUITE B107, VERO BEACH, FL 32960-4873
(772) 226-5026
(772) 226-7682
Mailing address
777 37TH ST, SUITE B107, VERO BEACH, FL 32960-4873
(772) 226-5026
(772) 226-7682
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5202883
FL
Other
Enumeration date
08/02/2013
Last updated
08/02/2013
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