Individual
HOLLY DAWN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
111 LAFAYETTE ST STE 202, SAINT MARYS, WV 26170-1059
(304) 684-2656
Mailing address
2417 MCKIM CREEK RD, PENNSBORO, WV 26415-8026
(304) 771-7458
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
108215
WV
Other
Enumeration date
02/19/2024
Last updated
02/19/2024
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