| NPI | 1669048211 |
|---|---|
| Former Name | CEREASA LEEANN MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80521-032) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-134071-032) |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2021-09-17 |