Moore, Mary A
Moore, Mary A is an individual health care provider with primary practice located at 3801 Decorah Rd , West Bend WI 53095-9597. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Moore, Mary A can be contacted via phone (704) 529-6161.Contact Information
Primary practice address
3801 Decorah Rd
West Bend WI 53095-9597
Phone: (704) 529-6161
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 1744-33 | Wisconsin |
Profile Details
| NPI number | 1972598753 |
|---|---|
| LBN Legal business name | Moore, Mary A |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 16th, 2005 |
| Last updated | May 6th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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