NPI | 1073500658 |
---|---|
Other Name | JEANNE MARIE CARNEY MOORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024168326) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 152237-0) |
Enumeration Date | 2005-09-29 |
Last Update Date | 2009-09-16 |