Most Relevant Information
Provider Data
| NPI Number: | 1003539388 |
| Provider Name: | MARIAH K MOORE |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 4704311259 |
Most Important Dates
| Enumeration Date: | 09/22/2022 |
| Last Updated: | 11/20/2023 |
Provider Practice Location
815 N CLARE AVE
HARRISON
MI
486258176
Practice Location Phone/Fax
| Phone: | 9895394434 |
| Fax: |
Provider Mailing Location
4000 WELLNESS DR
MIDLAND
MI
486702000
Provider Mailing Phone/Fax
| Phone: | 9898393000 |
| Fax: |