| NPI | 1205635810 |
|---|---|
| Former Name | MICHELLE LYNN MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5022424) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 364350) |
| Enumeration Date | 2025-03-08 |
| Last Update Date | 2025-06-21 |