| NPI | 1154609295 | 
|---|---|
| Former Name | DONNA MARIE LODGE-MOORE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP120751) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 526019) | 
| 363LF0000X Nurse Practitioner, Family (Licence: LA AP06526) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 21284) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP60359515) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 21284) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP60359615) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP120751) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402939) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP60359515) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA AP06526) | |
| Enumeration Date | 2011-07-22 | 
| Last Update Date | 2023-04-11 |