Most Relevant Information
Provider Data
| NPI Number: | 1003016460 |
| Provider Name: | JENNIFER MARIE MOORE RN, BSN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WM0705X |
| Specialty: | Registered Nurse |
| License Number: | R51303 |
Most Important Dates
| Enumeration Date: | 07/23/2007 |
| Last Updated: | 03/13/2014 |
Provider Practice Location
516 E NIZHONI BLVD
GALLUP
NM
873015748
Practice Location Phone/Fax
| Phone: | 5057221000 |
| Fax: |
Provider Mailing Location
PO BOX 1337
GALLUP
NM
873051337
Provider Mailing Phone/Fax
| Phone: | 5057221000 |
| Fax: |