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1629352901
SUSAN MICHELLE MOULTRIE
VICTORVILLE, CA
NPI
1629352901
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Former Name
SUSAN MICHELLE MOULTRIE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 12560)
Enumeration Date
2011-10-04
Last Update Date
2024-10-31
Business Address
Ms. SUSAN MICHELLE MOULTRIE Nurse Practitioner
12830 HESPERIA RD STE CDE
VICTORVILLE, CA 92395-7788
Phone number: 760-684-8999
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Mailing Address
Ms. SUSAN MICHELLE MOULTRIE Nurse Practitioner
4800 CITRUS AVE APT 5104
FONTANA, CA 92336
Phone number: 770-712-3049
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