MISTY MOORE IVY

OLIVE BRANCH, MS
NPI1063465482
Other NameMISTY ANN MOORE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MS  r860233)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: TN  apn11904)
Enumeration Date2006-05-18
Last Update Date2024-06-20
Business Address
Mrs. MISTY MOORE IVY C.R.N.P.
7203 GOODMAN RD
OLIVE BRANCH, MS 38654-1906
Phone number: 901-759-2322
Mailing Address
Mrs. MISTY MOORE IVY C.R.N.P.
1350 FORREST LAKE CV
HERNANDO, MS 38632-7500
Phone number: 901-759-2322