| NPI | 1508591801 |
|---|---|
| Former Name | BETHANY R MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CO 0997747) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO 0997747) |
| Enumeration Date | 2022-07-20 |
| Last Update Date | 2025-02-05 |