Doctor Name: | LISA MOORE |
NPI Number: | 1255705299 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 119904 |
Business Practice Address: | 5900 Saratoga Rd #11 Asbury, IA - 520022124 |
Business Phone Number: | 5632313521 |
Business Fax Number: | 5632313522 |
Mailing Address: | 2005 Asbury Rd, DUBUQUE |
State: | IA |
Postal Code: | 520013042 |
Phone Number: | 5635837357 |
Fax Number: | 8882433455 |
NPI Enumeration Date: | 11/13/2015 |
NPI Last Update Date: | 11/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC1500X |
License Number: | 119904 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |