| NPI | 1720688369 |
|---|---|
| Former Name | MELINDA MARIE MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 276769) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN148487) |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2024-04-07 |