| Doctor Name: | MRS. JERI JUDITH MOORE |
| NPI Number: | 1144643339 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 135629 |
| Business Practice Address: | 618 Dallas St Dexter, IA - 500707724 |
| Business Phone Number: | 5154013731 |
| Business Fax Number: | |
| Mailing Address: | 618 Dallas St, DEXTER |
| State: | IA |
| Postal Code: | 500707724 |
| Phone Number: | 5154013731 |
| Fax Number: | |
| NPI Enumeration Date: | 01/24/2014 |
| NPI Last Update Date: | 01/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WW0000X |
| License Number: | 135629 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Wound Care |
| Taxonomy Definition: | |