Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 02587 | NM |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 4704316175 | MI |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 6820 | WI |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | RN1012553 | DC |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | R180060 | MD |
NPI | 1629340906 |
---|---|
Provider Name | Josephine Moore |
First Address | Rockville, MD 20847-2151 |
Second Address | North Bethesda, MD 20852-4119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2012 |
Last Update Date | 26/07/2021 |