NPI | 1992173330 |
---|---|
Former Name | PEGGY L. MOORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009842) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1069555) |
Enumeration Date | 2015-09-02 |
Last Update Date | 2023-11-27 |